The Netherlands Journal of Medicine, september 2011
Crowding in the emergency department (ED) occurs when the identified need for emergency services exceeds available resources for patient care in the ED, hospital, or both. The result of ED crowding is reduced quality of care, affecting morbidity, mortality and patient satisfaction. This is illustrated by two recent studies that demonstrate a direct association between ED crowding and an increased risk of mortality. In addition, delays in patient treatment also effect outcomes in conditions that benefit from short door-to-needle times, such as myocardial infarction, stroke, sepsis, meningitis and pneumonia. One of the most important indicators of quality of care and patient satisfaction is pain management, which is negatively affected by ED crowding as well. Therefore, understanding the causes, effects and solutions of ED congestion is important and subject of research questions.