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Crowding In Health Care

Decent Essays
Background: Emergency Department (ED) crowding has become an increasing problem, so much that wait times has increased exponentially. The American College of Emergency Physicians (ACEP) states crowding as, “the identified need for emergency services exceeds available resources for patient care in the ED, hospital or both” (ACEP, 2015). According to the Society for Academic Emergency Medicine it explains that, “the cause of ED overcrowding is multifactorial; however, it is generally considered to be a combination of input, throughput, and output stressors”(Bullard et al., 2011).
Methods: This is a multiple site cross-sectional study with a randomized sample. In collaboration with the National Hospital Ambulatory Medical Care Survey the study
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The American College of Emergency Physicians (ACEP) states crowding as, “the identified need for emergency services exceeds available resources for patient care in the ED, hospital or both” (acep.org). What is fueling these incidents is the rapid increase in ED visits combined with diminishing numbers of ED. In a study conducted by the Academic Emergency Medicine explains that, “ ED crowding is worsening in the US as demonstrated by longer waiting times to see clinicians and is likely exacerbated by the worsening problem of ED boarding, where admitted patients often stay for long periods in the ED waiting for inpatient bed placement” (Aronsky et al., 2011; p. 528). Crowding could possibly affect clinical outcomes, such as mortality, which may adversely lead to delays for time sensitive patients. These outcomes would then lead to a higher rate of patient dissatisfaction within the ED, thus leading to an increase amount of patients left without being seen (LWBS) rates. Unsurprisingly, what can be considered accountable for the rapid increase in ED visits is due to the combination of the Emergency Medical Treatment and Active Labor Act (EMTALA) and the induction of the Affordable Care Act (ACA). EMTALA imposes statutes on hospitals and their EDs. These statutes prevent hospitals that accept payments from the Center for Medicare and Medicaid Services (CMS) from rejecting patients, refusing to treat them or transferring them to a different hospital because of their inability to pay. Which, ultimately may lead to more visits depending on the location. With EMTALA and the ACA already being effective Jan. 1 a Health Affairs article conducted a survey and found that, “a total ED visits have increased an estimated 18 to 26 percent, while the number of EDs decreased between 9 and 12 percent, resulting in a 78 percent increase in visits per
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