How Do Patients Fare When the Emergency Department Is Full?

Emergency Department Crowding and Decreased Quality of Pain Care

...On average, patients in the ED at times of high census waited 55 minutes longer for documented pain assessments and up to 43 minutes longer to receive analgesics.[3]...

What can be done to prevent these outcomes? Changes can be made in the ED to increase internal efficiency, such as streamlining registration and triage, providing "fast track" areas for uncomplicated problems, expanding observation units, and using nurse-initiated protocols for care. However, much of the solution will require taking actions outside the ED, such as moving the entire hospital toward a 24 hours/day, 7 days/week operational culture; coordinating elective hospital admissions and transfers more effectively; using discharge lounges for patients; and establishing hospital-wide protocols for addressing capacity issues.