Assessing Issues of Overcrowding in Emergency Room of a Tertiary Care Hospital

ER crowding is a global issue. Emergency patients are hard to schedule, since by definition they have no appointment with the physician and arrive at random. Major causes behind emergency room crowding are identified as increasing demand for health services, inability to transfer the emergency patients to inpatient beds, slow throughput of patient, unavailability of specialty consultation, delays in laboratory and radiographic studies, insufficient ER space, slow or incompatible information system are major contributors.

To analyze the current situation/indicators of ER clogging, to identify the systems gap behind the ER clogging, and to come up with evidence-based recommendations for quality management of ER clogging issues.

Data collection tool was developed for the purpose of primary data collection. 30 cases were randomly selected in the ER. Existing data was reviewed to compare it with the primary data from our observations and to conclude the findings.

The indicators to access ER clogging demonstrate significant variation from the JCI benchmark. Some of the important factors causing the clogging include: Delay in discharge of patients from the wards, delay in specialist consultation in the ER, and Laboratory and Radiology reporting delays.