Hospital overcrowding is a major challenge facing health care systems. It reduces the efficiency and effectiveness of patient flow throughout a hospital, leads to poor outcomes for patients, increases staff stress and burnout, and can contribute to medical errors. It also negatively affects patient satisfaction, which is often a top priority for consumers of health care services.
The problem is exacerbated by difficulty in matching a patient to an appropriate setting and service, and by delays in discharging a patient to home or community-based settings. In these situations, a person may be left in the ED for too long, resulting in frustration and even a return visit. Alternatively, a patient who is awaiting a bed in an acute inpatient unit may find themselves waiting for over six hours before they can be admitted. Such delays are referred to as “leave without being seen” (LWBS) rates, and they are a national concern that has doubled in recent years.
The issue is complex, and the solutions are varied. However, the health care community should be aware of the potential for worse outcomes when overcrowding occurs, and take active steps to identify and implement a system of care that will address the root causes and aggravating factors. This will include implementing a program to prevent overcrowding in the ED, including a full capacity protocol for admitting patients when space is limited. In addition, efforts must be made to improve the ability of families and providers to work together to identify and secure community-based health care services that can prevent overutilization of hospital beds.
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