PT  - JOURNAL ARTICLE
AU  - S Trzeciak
AU  - E P Rivers
TI  - Emergency department overcrowding in the United States: an emerging threat to patient safety and public health
AID  - 10.1136/emj.20.5.402
DP  - 2003 Sep 01
TA  - Emergency Medicine Journal
PG  - 402--405
VI  - 20
IP  - 5
4099  - http://emj.bmj.com/content/20/5/402.short
4100  - http://emj.bmj.com/content/20/5/402.full
SO  - Emerg Med J2003 Sep 01; 20
AB  - Numerous reports have questioned the ability of United States emergency departments to handle the increasing demand for emergency services. Emergency department (ED) overcrowding is widespread in US cities and has reportedly reached crisis proportions. The purpose of this review is to describe how ED overcrowding threatens patient safety and public health, and to explore the complex causes and potential solutions for the overcrowding crisis. A review of the literature from 1990 to 2002 identified by a search of the Medline database was performed. Additional sources were selected from the references of the articles identified. There were four key findings. (1) The ED is a vital component of America’s health care “safety net”. (2) Overcrowding in ED treatment areas threatens public health by compromising patient safety and jeopardising the reliability of the entire US emergency care system. (3) Although the causes of ED overcrowding are complex, the main cause is inadequate inpatient capacity for a patient population with an increasing severity of illness. (4) Potential solutions for ED overcrowding will require multidisciplinary system-wide support.