The Relationship Between Emergency Department Crowding and Patient Outcomes: A Systematic Review
Article first published online: 19 DEC 2013
© 2013 Sigma Theta Tau International
Journal of Nursing Scholarship
Volume 46, Issue 2, pages 106–115, March 2014
How to Cite
Carter, E. J., Pouch, S. M. and Larson, E. L. (2014), The Relationship Between Emergency Department Crowding and Patient Outcomes: A Systematic Review. Journal of Nursing Scholarship, 46: 106–115. doi: 10.1111/jnu.12055
- Issue published online: 6 MAR 2014
- Article first published online: 19 DEC 2013
- Manuscript Accepted: 21 SEP 2013
- Emergency department crowding;
- patient outcomes
Emergency department (ED) crowding is a significant patient safety concern associated with poor quality of care. The purpose of this systematic review is to assess the relationship between ED crowding and patient outcomes.
We searched the Medline search engine and relevant emergency medicine and nursing journals for studies published in the past decade that pertained to ED crowding and the following patient outcome measures: mortality, morbidity, patient satisfaction, and leaving the ED without being seen. All articles were appraised for study quality.
A total of 196 abstracts were screened and 11 articles met inclusion criteria. Three of the eleven studies reported a significant positive relationship between ED crowding and mortality either among patients admitted to the hospital or discharged home. Five studies reported that ED crowding is associated with higher rates of patients leaving the ED without being seen. Measures of ED crowding varied across studies.
ED crowding is a major patient safety concern associated with poor patient outcomes. Interventions and policies are needed to address this significant problem.
This review details the negative patient outcomes associated with ED crowding. Study results are relevant to medical professionals and those that seek care in the ED.