CAUSES OF EMERGENCY DEPARTMENT OVERCROWDING IN A SUBURBAN COMMUNITY HOSPITAL

Emergency department (ED) overcrowding is a serious problem facing the medical community. Overcrowding can lead to increased ED boarding times, which in turn, can lead to not only patient dissatisfaction with their level of care but increased inpatient length of stays and mortality. Methods A review of the literature showed many possible contributing factors to this problem, including lack of access to primary care services, holding of certain types of patients for transfer, boarding of admitted patients, and the time of day and day of the week of presentation to the ED. A quantitative, chart review based, quality improvement study was undertaken to identify the possible causes of overcrowding in this suburban community ED. Results Our study showed that while ED boarding time and inpatient discharge order to departure time were not statistically significant predictors of the measures of overcrowding, it was found that ED door to medical screening examination (MSE) time was a statistically significant predictor of average ED DC LOS (r = .939, p < .001), total diversion time (r < .680, p = .001) and number of diversion instances (r = .650, p = .001), and admission time of day (TOD) was a statistically significant predictor of average ED iv DC LOS (r = .899, p < .001), total diversion time (r = .565, p = .004) and number of diversion instances (r = .541, p = .006).