Overcrowding in emergency department: an international issue

• Published in: Internal and emergency medicine Vol. 10; no. 2; pp. 171 - 175
• Main Authors: Di Somma, Salvatore, Paladino, Lorenzo, Vaughan, Louella, Lalle, Irene, Magrini, Laura, Magnanti, Massimo
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.03.2015; Springer Nature B.V
• Subjects: Bed Occupancy - economics; Costs and Cost Analysis; Crowding; Delivery of Health Care - economics; Delivery of Health Care - methods; EM - Editorial; Emergency Service, Hospital - statistics & numerical data; Emergency Service, Hospital - trends; Humans; Internal Medicine; Internationality; Medicine; Medicine & Public Health; Organizational Innovation; Time Factors; Overcrowding; Organizational procedures; Emergency department
• ISSN: 1828-0447; 1970-9366
• DOI: 10.1007/s11739-014-1154-8

Overcrowding in the emergency department (ED) has become an increasingly significant worldwide public health problem in the last decade. It is a consequence of simultaneous increasing demand for health care and a deficit in available hospital beds and ED beds, as for example it occurs in mass casualty incidents, but also in other conditions causing a shortage of hospital beds. In Italy in the last 12–15 years, there has been a huge increase in the activity of the ED, and several possible interventions, with specific organizational procedures, have been proposed. In 2004 in the United Kingdom, the rule that 98 % of ED patients should be seen and then admitted or discharged within 4 h of presentation to the ED (‘4 h rule’) was introduced, and it has been shown to be very effective in decreasing ED crowding, and has led to the development of further acute care clinical indicators. This manuscript represents a synopsis of the lectures on overcrowding problems in the ED of the Third Italian GREAT Network Congress, held in Rome, 15–19 October 2012, and hopefully, they may provide valuable contributions in the understanding of ED crowding solutions.