Overcrowded ERs: analysis of the phenomenon and managing proposals

The “overcrowding” in Emergency Departments (EDs) and its potentially negative consequences, is a well known phenomenon in western countries. The causes of this phenomenon in this area are: constantly decreased number of hospital beds, increased number of ED visits and demographic changes (increasing prevalence of elderly people and migrants). Overcrowding in EDs accounts different timing of various care-paths (e.g. door-to-balloon time in STEMI) and also influences the degree of care given to patients. Moreover overcrowding has also been considered as a first-line cause of doctor’s and nurse’s burnout and of verbal or physical assault. The overcrowding phenomenon seems to be more effectively influenced by interventions directed to improve patient’s output from ED to wards; by contrast interventions directed to limit ED visits failed to be effective.