study highlights dangers of excessively busy emergency rooms

One of the unfortunate realities of life in a well-populated area is that going to the emergency room for treatment can sometimes prove to be a difficult — and downright frightening –proposition. The reason? The sheer number of patients coupled with limited staff and a limited number of beds can sometimes make for a very long wait and even result in the exacerbation of symptoms as patients are forced to watch the hours tick by.

In fact, emergency rooms/departments sometimes get so crowded that ambulances are actually diverted while en route to other less busy hospitals.

In light of this sobering reality, it’s only natural to presume that that those patients who come to the emergency room on the busiest days — and are actually admitted — would tend to have more negative outcomes.

Interestingly, a recently published study in the Annals of Emergency Medicine by researchers at Oregon Health and Science University essentially verifies this presumption, finding that the most hectic days in emergency rooms are not only linked to a higher inpatient mortality risk, but higher costs and longer stays.

A complete discussion of how the researchers structured their rather complex study is clearly beyond the scope of this blog post. However, in very basic terms, they gathered data on daily ambulance diversion and hospitals discharges in the state of California in 2007. From there, they identified the busiest days on which ambulances were diverted and examined how patients admitted to the hospital via the emergency room on these days fared in their treatment.

They discovered the following:

  • Patients had a five percent greater risk of death prior to discharge, hospital stays that were .8 percent longer and hospital costs that were 1 percent higher
  • In total, overcrowded emergency rooms resulted in 300 additional patient deaths, 6,200 extra days in the hospital and $17 million in costs in 2007

Why did patients admitted to the hospital via the emergency room on these crowded days fare so much worse?

The researchers theorize that delays in treating certain time-sensitive conditions (i.e., heart attacks, pneumonia, etc.) along with frequent shift changes and attention being constantly diverted to new patients likely played a major role.

There is no doubt that the atmosphere in emergency rooms can be chaotic. However, this is no excuse for providing patients with substandard and dangerous care. Hospitals should be well aware of their limitations and must always do what is necessary to keep each and every patient safe.

Source: Med Page Today, “Crowded EDs may be serious health hazard,” Crystal Phend, Dec. 12, 2012

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