Emergency Room Overcrowding and Wait Times: the Direct Impact on Patient Care

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Emergency Room Overcrowding and Wait Times:
The Direct Impact on Patient Care
Joann Hobbs
Spalding University

Abstract
Background. This study was done to determine if prolonged wait times in the emergency department (ED) effect overall care and treatment of patients.
Methods. This project used questionnaires that were distributed to patients at 6 local emergency rooms, electronic data collected from said facilities, as well as interviews from the nursing staff on duty at the time of distribution of the questionnaires. Data collected was used to determine: 1.) What is general perception\definition of overcrowding, 2.) Average wait times from waiting room to beginning of treatment, 3.) Pt’s impression of care and treatment received, and 4.) Condition of pt’s seen during periods of overcrowding five days out from discharge.

Results. This study has not been conducted yet.
Conclusion. There is evidence in researching literature on these topics to support that this study should be conducted as there is little to support this topic from a nursing stand point.
Keywords. emergency department, overcrowding, throughput, boarding, wait times, patient care.

Introduction
Emergency departments (ED) through out the United States see roughly 136 million patients each year, based on data from 2009 (National, 2011). Many of these visits are non-urgent, others are repeat visits for the same problems. Due to these and several other factors the ED’s are becoming overcrowded and the wait times are increasing drastically. On average in 2009, a patient spent a total of four hours and seven minutes in the emergency department (Press, 2009). One would think nowadays, with reimbursement (Medicare and other funding) being based so greatly on patient satisfaction scores that the hospitals would figure a way to resolve this issue. Hospitals cannot control the amount of people that enter their emergency rooms for treatment, nor can they alter the perception of what is considered overcrowding. The purpose of this study is to determine if wait times, due to overcrowding, effect the care and treatment of patients.

In this study, we will be using descriptive-correlating research methods to examine the information received. The analysis of data from the six local hospitals (located in Kentucky), patients and nursing staff will allow us to test whether patient care is adversely affected by delays. The International Review Board has approved this study. Copies of the permission form (to the IRB) and the informed consent that was given to all participants, has been attached to this study. Definitions

Overcrowding: refers to an extreme volume of patients in ED treatment areas, forcing the ED to operate beyond its capacity (Gordon, Billings, Asplin & Rhodes, 2011). Emergency Department: (in a health care facility) a section of an institution that is staffed and equipped to provide rapid and varied emergency care, especially for those who are stricken with sudden and acute illness or who are the victims of severe trauma. The emergency department may use a triage system of screening, and classifying clients to determine priority needs for the most efficient use of available personnel and equipment (Mosby's medical dictionary, 2009). Boarding: (A patient who is boarded) - is defined as a patient who remains in the emergency department after the patient has been admitted to the facility, but has not been transferred to an inpatient unit (ACEP, 2011). *Each of my studies collected different types of data and measured it in different ways. In defining Operational Definition (When applied to data collection, it is a clear, concise, and detailed definition of a measure. It ensures that those collecting data do so consistently), it could be said that each had a different definition of measure.

Methods
Sample
Over a period of six months we surveyed patients that arrived to several local ED’s for evaluation and treatment. Each...
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