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No room at the inn: overcrowding in Ontario’s emergency departments

Published online by Cambridge University Press:  21 May 2015

Alan J. Drummond
Alan J. Drummond*
Affiliation:
Section on Emergency Medicine, Ontario Medical Association, Toronto, Ont., Department of Family Medicine, University of Ottawa, Ottawa, Ont., and Department of Family Medicine, Queen’s University, Kingston, Ont.
*
20 Drummond St. W, Perth ON K7H 2J5; fax 613 267-8770, [email protected]

Abstract

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Type
ED Administration • Administration du DU
Information
Canadian Journal of Emergency Medicine , Volume 4 , Issue 2 , March 2002 , pp. 91 - 97
Copyright
Copyright © Canadian Association of Emergency Physicians 2002

References

1.Canadian Association of Emergency Physicians and National Emergency Nurses Affiliation. Joint Position Statement on emergency department overcrowding. CJEM 2001;3(2):82–4.CrossRefGoogle Scholar
2.Drummond, A.No room at the inn: emergency department overcrowding in Ontario. A review of the medical literature and suggestions for potential solutions. Toronto (ON): Section on Emergency Medicine, Ontario Medical Association; 2000 Dec 14.Google Scholar
3.Saunders, CE, Makens, P, Leblanc, L.Modeling emergency department operations using advanced computer simulation systems. Ann Emerg.Med 1989;18:134–40.CrossRefGoogle ScholarPubMed
4.Graff, L.Overcrowding in the ED: an international symptom of health care system failure [editorial]. Am J Emerg Med 1999; 17:208–9.Google Scholar
5.Graff, L.Emergency physician workload: a time study. Ann Emerg Med 1993;22:1156–63.Google Scholar
6.Shih, F, Huei-Ming, M, Chen, SC, Wang, HP, Fang, CC, Shyu, RS.overcrowding in Taiwan: facts and strategies. Am J Emerg Med 1999;17:196–202.CrossRefGoogle ScholarPubMed
7.Miro, O.Decreased health care quality associated with emergency department overcrowding. Eur J Emerg Med 1999; 6:105–7.CrossRefGoogle ScholarPubMed
8.Kohn, M.Medical gridlock [editorial]. J Emerg Med 1990;8:773–4.Google Scholar
9.Gallagher, EJ, Lynn, S.The etiology of medical gridlock: causes of emergency department overcrowding in New York City. J Emerg Med 1990;8:785–90.CrossRefGoogle ScholarPubMed
10.McNamara, P.The sagging safety net: emergency departments on the brink of crisis. Hospitals 1992;Feb 20:26–40.Google Scholar
11.Kellerman, A.Too sick to wait [editorial]. JAMA 1991; 266:1123–4.Google Scholar
12.Andrulis, D, Kellermann, A, Hintz, E, Hackman, B, Weslowski, V.Emergency departments and crowding in United States teaching hospitals. Ann Emerg Med 1991; 20: 980–6.Google Scholar
13.American College of Emergency Physicians Overcrowding Task Force. Measures to deal with emergency department overcrowding. Ann Emerg Med 1990;19:944–5.Google Scholar
14.Feferman, I, Cornell, C.How we solved the overcrowding problem in our emergency department. CMAJ 1989;140:273–6.Google Scholar
15.Dickinson, G.Emergency department overcrowding. CMAJ 1989;140:270–1.Google Scholar
16.Brown, E, Goel, V.Factors related to emergency department use: results from the Ontario Health Survey 1990. Ann Emerg Med 1994; 24:1083–91.CrossRefGoogle ScholarPubMed
17.Kollek, D.Overwhelmed in emergency: examining ER status at Hamilton Civic Hospitals. Ont Med Rev 1990;Dec:11–3.Google Scholar
18.Maloney, J.Hospital emergency department closures: a position statement. Ottawa General Hospital 1989;Jan 12.Google Scholar
19.Lyver, M.Emergency unit overcrowding. Toronto (ON): Provincial (Ontario) EHS Advisory Committee on ED Overcrowding; 1988.Google Scholar
20.Kondro, W.Relief at a price for emergency wards in Ontario. Lancet 1998;352:1451.CrossRefGoogle Scholar
21.Ontario Hospital Association (OHA), Ontario Ministry of Health (OMA). OHA Region 3: Emergency Services Working Group final report. 1998 April.Google Scholar
22.Ontario Hospital Association. A matter of hospital resources: an emergency care action plan. Ontario Hospital Association. August 2000.Google Scholar
23.Pinker, S.Latest ER crisis hit communities large and small. CMAJ 2000;162:559–60.Google ScholarPubMed
24.Derlet, RW, Richards, JR.Overcrowding in the nation’s emergency departments: complex causes and disturbing effects. Ann Emerg Med 2000;35(1):63–7.CrossRefGoogle ScholarPubMed
25.Kellermann, A.Déjà vu [editorial]. Ann Emerg Med 2000; 35(1):83–5.Google Scholar
26.Richard, J, Navarro, M.Survey of directors of emergency departments in California on overcrowding. Western J Med 2000; 172:385–8.CrossRefGoogle Scholar
27.Bagust, A, Place, M, Posnett, J.Dynamics of bed use in accommodating emergency admissions: stochastic simulation model. BMJ 1999;319:155–8.CrossRefGoogle ScholarPubMed
28.Lynn, S, Kellermann, A.Critical decision making: managing the emergency department in an overcrowded hospital. Ann Emerg Med 1991;20:105–10.CrossRefGoogle Scholar
29.Fromm, RE, Gibbs, LR, McCallum, WG, Niziol, C, Babcock, J, Gueler, AC, et al. Critical care in the emergency department: a time-based study. Crit Care Med 1993;21:970–6.CrossRefGoogle ScholarPubMed
30.Davis, B, Sullivan, S, Levine, A, Dallara, J.Factors affecting ED length-of-stay in surgical critical care patients. Am J Emerg Med 1995;13:495–500.CrossRefGoogle ScholarPubMed
31.Kellerman, A.Nonurgent emergency department visits: meeting an unmet need [editorial]. JAMA 1994;271:1953–4.Google Scholar
32.Nonurgent emergency department visits — Whose definition? [editorial]. Ann Emerg Med 1994;24:961–2.CrossRefGoogle Scholar
33.O’Brien, G, Shapiro, M, Woolard, R, O’Sullivan, P, Stein, M.“Inappropriate” emergency department use: a comparison of three methodologies for identification. Acad Emerg Med 1996;3:252–7.CrossRefGoogle ScholarPubMed
34.Afilalo, M.Emergency department use and misuse. J Emerg Med 1995;13:259–64.Google Scholar
35.Baker, D, Stevens, C, Brock, R.Regular source of ambulatory care and medical care: utilization by patients presenting to a public hospital emergency department. JAMA 1994;271:1909–12.Google Scholar
36.Lucas, R, Sanford, S.An analysis of frequent users of emergency care at an urban university hospital. Ann Emerg Med 1998; 32:563–8.Google Scholar
37.Williams, R.The costs of visits to emergency departments. N Engl J Med 1996;334:642–6.Google Scholar
38.Selby, J.Effect of a co-payment on use of the emergency department in a health maintenance organization. N Engl J Med 1996;334:635–41.Google Scholar
39.Drummond, A.Urgency in the emergency [letter]. CMAJ 1996; 155:1038.Google ScholarPubMed
40.Thompson, J.Health care reform and emergency outpatient use of rural hospitals in Alberta, Canada. J Emerg Med 1995;13:415–21.Google Scholar
41.Gill, J.Nonurgent use of the emergency department: Appropriate or not? Ann Emerg Med 1994;24:953–7.Google Scholar
42.Steinbrook, R.The role of the emergency department [editorial]. N Engl J Med 1996;334:657–8.CrossRefGoogle ScholarPubMed
43.Vosk, A.Response of consultants to the emergency department: a preliminary report. Ann Emerg Med 1998;32:574–7.Google Scholar
44.Miro, O, Antonio, MT, Jimenez, S, De Dios, A, Sanchez, M, Borras, A, et al: Decreased health care quality associated with emergency department overcrowding. Eur J Emerg Med 1999;6:105–7.Google Scholar
45.Hansagi, H.Trial of a method of reducing inappropriate demands on a hospital emergency department. Public Health 1987;101:99–105.CrossRefGoogle ScholarPubMed
46.Krochmal, P, Riley, T.Increased health care costs associated with ED overcrowding. Am J Emerg Med 1994;12:265–6.Google Scholar
47.Redelmeier, D.No place to unload: a preliminary analysis of the prevalence, risk factors and consequences of ambulance diversion. Ann Emerg Med 1994;23:43–7.Google Scholar
48.Fernandes, C, Bouthillette, F, Raboud, J, Bullock, L, Moore, C, Christenson, J, et al: Violence in the emergency department: a survey of health care workers. CMAJ 1999;161:1245–8.Google ScholarPubMed
49.Morrison, L.Abuse of emergency department workers: An inherent career risk or a barometer of the evolving health care system? CMAJ 1999;161:1262–3.Google ScholarPubMed
50.Andrews, L.Wellness for emergency physicians. Dallas (TX): American College of Emergency Physicians; 1995.Google Scholar
51.Harrison, P.Life in the ER: wild nights, mounting stress and mid-40s burnout. CMAJ 1993;148:1598–600.Google Scholar
52.Lloyd, S.Burnout, depression, life and job satisfaction among Canadian emergency physicians. J Emerg Med 1994;12:559–65.Google Scholar
53.Drummond, A.A review of the draft standards for hospital emergency services in Ontario. Toronto (ON): Section on Emergency Medicine, Ontario Medical Association: 1999.Google Scholar
54.Drummond, AJ, Drummond, R.The Alternative Funding Agreement for emergency services in Ontario: a new compensation method for rural emergency departments [commentary]. CJEM 2000;2(4):232–6.Google Scholar
55.Fernandes, C.Use of continuous quality improvement to facilitate patient flow through the triage and fast-track areas of an emergency department. J Emerg Med 1995;13:847–55.Google Scholar
56.Fernandes, C.Does reduced length of stay decrease the number of emergency department patients who leave without seeing a physician. J Emerg Med 1997;15:397–9.Google Scholar
57.Meislin, H, Coates, S, Cyr, J, Valenzuela, T.Fast track: urgent care within a teaching hospital emergency department: Can it work? Ann Emerg Med 1988;17:453–6.Google Scholar
58.Ellis, G.Use of physician extenders and fast tracks in United States emergency departments. Am J Emerg Med 1997;15:229–32.Google Scholar
59.Brillman, J.Management of observation units. Ann Emerg Med 1995;25:823–30.Google Scholar
60.Brennan, J.Guidelines for ambulance diversion. Ann Emerg Med 2000;36:376–7.Google Scholar