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American Academy of Emergency Medicine

AAEM Position Statement on Emergency Department Crowding

Background

  • Annual visit volume to U.S. emergency departments continues to increase,
  • The number of U.S. emergency departments continues to decrease,
  • ED crowding is a serious nationwide problem that has multiple causes,
  • ED crowding is a result of decreasing total hospital and health systems capacity and inability to meet the demand for care, and
  • A growing body of evidence suggests that ED crowding results in a decrease in the quality of care, including increased medical errors, delayed diagnosis, increased pain and suffering, disability, and in some cases death.

It is the position of the American Academy of Emergency Medicine that:

  • ED crowding represents a failure of multiple hospital systems to address patient access to health care. It is not a problem confined only to the ED. In addition, ED crowding reflects broader disparities in access to primary care.
  • Emergency physicians and health policy researchers should continue to study the problem of ED crowding and possible solutions.
  • ED crowding negatively affects emergency care providers, threatening the well-being, performance and retention of this vital work force.

  • The Academy calls on hospitals and health care systems to:
  • Create, test, and refine strategies to alleviate ED crowding,
  • Assign priority for inpatient beds to patients admitted from the ED,
  • Keep the public and community informed about patient flow, expected wait times, and care available in local EDs.

  • The Academy calls on federal, state and local governments to:
  • Provide reasonable and rapid access to primary care for all under- and uninsured individuals,
  • Increase significantly reimbursements to EDs and hospitals for all care rendered in Emergency Departments,
  • Finance increases in hospital capacity, including expansion of: ED space and personnel, number of staffed hospital beds, ancillary services and availability of specialists.

 

5/25/05