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. 2013 Feb;14(1):1-10.
doi: 10.5811/westjem.2011.5.6700.

Perceptions of emergency department crowding in the commonwealth of pennsylvania

Jesse M Pines  1 , Joshua A Isserman, John J Kelly
Affiliations

Perceptions of emergency department crowding in the commonwealth of pennsylvania

Jesse M Pines et al. West J Emerg Med. 2013 Feb.

Abstract

Introduction: The state of emergency department (ED) crowding in Pennsylvania has not previously been reported.

Methods: We assessed perceptions of ED crowding by surveying medical directors/chairs from Pennsylvania EDs in the spring of 2008.

Results: A total of 106 completed the questionnaire (68% response rate). A total of 83% (86/104) agreed that ED crowding was a problem; 26% (27/105) reported that at least half of admitted patients boarded for more than 4 hours. Ninety-eight percent (102/104) agreed that patient satisfaction suffers during crowding and 79% (84/106) stated that quality suffers. Sixty-five percent (68/105) reported that crowding had worsened during the past 2 years. Several hospital interventions were used to alleviate crowding: expediting discharges, 81% (86/106); prioritizing ED patients for inpatient beds, 79% (84/106); and ambulance diversion, 55% (57/105). Almost all respondents who had improved ED operations reported that it had reduced crowding.

Conclusion: ED crowding is a common problem in Pennsylvania and is worsening in the majority of hospitals, despite the implementation of a variety of interventions.

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Conflict of interest statement

Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding, sources, and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

Figures

Figure 1
Figure 1
The prevalence of emergency department (ED) crowding and boarding in Pennsylvania hospitals.
Figure 2
Figure 2
Changes in emergency department (ED) crowding, primary care access, and on-call specialist availability in Pennsylvania (n = 105).
See this image and copyright information in PMC

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