Emergency rooms are not doing enough to ease and prevent overcrowding, and it's harming patients.
That's according to a new study by medical researchers at George Washington University, Albany Medical College and Harvard Medical School, who examined crowding intervention strategies employed by hospitals between 2007 and 2010.
The good news is that during the time period examined by the study, hospitals increased the number of interventions aimed at easing overcrowding from an average of 5.2 to 6.6.
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But a troubling number of the most crowded hospitals did not adopt certain strategies that the researchers said could produce important effects. Among the top quartile of crowded hospitals, 19 percent did not adopt bedside registration and 94 percent did not use surgical scheduling smoothing.
In addition, while 46 percent of hospitals had "full-capacity protocols" in place, which allow a hospital to assign patients to wait in other areas of the hospital when ER beds are full, only 38 percent of the most crowded hospitals had such policies in place.
Dr. Leah Honigman Warner, the lead author of the study, explained to Kaiser Health News that a variety of potential interventions might force hospitals to invest in new technology or rewrite rules to ease scheduling. One intervention she cited was allowing patients to schedule elective surgeries on weekends.
"It is reassuring that a lot of these hospitals have a rise in adopting these interventions. But in the most crowded hospitals, they're not even doing half of the things they could do to reduce overcrowding."
Some hospitals, of course, are always going to be more vulnerable to overcrowding than others, based on factors out of their control. Those located in areas with a high uninsured population are more likely to get patients seeking non-emergency care.
While a number of high-profile public policies, notably the Patient Protection and Affordable Care Act, have sought to reduce that problem by insuring more people, the American Academy of Emergency Physicians has complained recently that many people with insurance are still resorting to the ER for basic medical services because their insurance plan does not include enough nearby primary care physicians or specialists nearby.
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