Overcrowding in Emergency Departments: Effects on Patients

Recently there has been increased discussion on the overcrowded conditions in many of California’s emergency departments. A recent article published in the Western Journal of Medicine details the result of a comprehensive survey among directors of California EDs. Over 96% reported episodic overcrowding in EDs and some reported nearly daily overcrowding. The results are also similar to that conducted in a survey nationally that included both teaching and non-teaching hospitals. Although the causes of overcrowding are complex and multifactorial, the key reason for overcrowding is because EDs are too small and understaffed for the population they serve. The impact of overcrowding deserves discussion. There are multiple effects of overcrowding and it is unfortunate that our patients have to suffer because EDs do not have the capacity to serve the public. Some of the effects of overcrowding that I have discovered in my discussions with emergency physicians throughout the state include the following: 1. Long waits for care. Long waits are the most common complaints from ED patients. A consequence of these delays includes the potential for minor medical problems to become more serious. Patients are unhappy with long waits and this dissatisfaction is reflected in an increasing number of patients who leave without being seen. 2. Prolonged pain and suffering. As a result of overcrowding, patients may experience prolonged pain and suffering because they are at the “back of the line.” (Cont. on page 3)