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Chapter 15 - Overcrowding, Triage, and Care Rationing
- By Samita M. Heslin, Peter Viccellio
Edited by Mark Curato, Weill Cornell Medicine, New York, Kaushal Shah, Weill Cornell Medicine, New York, Christopher Reisig, Weill Cornell Medicine, New York
Book:

Urban Emergency Medicine

Published online:

20 July 2023

Print publication:

03 August 2023, pp 184-190
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Summary

Emergency Departments (EDs) nationwide face overcrowding problems. This is particularly problematic in the urban milieu because of a large volume of patients, smaller physical footprint of EDs, more low-acuity cases, and increased cases needing additional services, such as social services. Overcrowded EDs have negative impacts on patient care and patient safety. There are several solutions to ED overcrowding. Hospital-level solutions include smoothing elective admissions across the week; discharging patients earlier in the day; discharging patients on the weekends; and the Full Capacity Action plan. ED-level solutions include incorporating a Team Triage model; improving radiology turnaround times; improving availability and timeliness of ancillary services; and improving timeliness of consultants.