This manuscript represents a component of the 2011 Academic Emergency Medicine Consensus Conference entitled “Interventions to Assure Quality in the Crowded Emergency Department (ED)” held in Boston, MA.
System Dynamics and Dysfunctionalities: Levers for Overcoming Emergency Department Overcrowding
Version of Record online: 13 DEC 2011
© 2011 by the Society for Academic Emergency Medicine
Academic Emergency Medicine
Special Issue: Proceedings of the 2011 AEM Consenus Conference: Interventions to Assure Quality in the Crowded Emergency Department Guest Editors: James R. Miner, MD Manish N. Shah, MD, MPH
Volume 18, Issue 12, pages 1255–1261, December 2011
How to Cite
Schiff, G. D. (2011), System Dynamics and Dysfunctionalities: Levers for Overcoming Emergency Department Overcrowding. Academic Emergency Medicine, 18: 1255–1261. doi: 10.1111/j.1553-2712.2011.01225.x
Funding for this conference was made possible (in part) by 1R13HS020139-01 from the Agency for Healthcare Research and Quality (AHRQ). The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services, nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government. This issue of Academic Emergency Medicine is funded by the Robert Wood Johnson Foundation.
The authors have no potential conflicts of interest to disclose.
Supervising Editor: James Miner, MD.
- Issue online: 13 DEC 2011
- Version of Record online: 13 DEC 2011
- Received July 20, 2011; revision received August 23, 2011; accepted August 23, 2011.
ACADEMIC EMERGENCY MEDICINE 2011; 18:1255–1261 © 2011 by the Society for Academic Emergency Medicine
Overcrowding of U.S. emergency departments (EDs) is a widely recognized and growing problem. This presentation offers the perspectives of a primary care physician (PCP) examining the problem at three levels: global health policy, quality process improvement, and more intimate clinical caring. It posits that ED overcrowding is actually a symptom of 10 more fundamental problems in U.S. health care and EDs: variations/supply-demand mismatch; primary care provider shortfalls; limited after-hours access; admission throughput challenges; clinical challenges related to discontinuity patients; clinical challenges related to those with special needs; interruptions; testing logistical challenges; suboptimal information systems; and fragmented/dysfunctional health insurance system, leaving many un- and underinsured.