Emergency room overcrowding is a chronic and systemic problem in public healthcare units, and affects almost every emergency department across the country. Overcrowding in ER has several negative impacts not only to patients, but also to the service providers. On the side of the patients, ER overcrowding exposes individuals to increased morbidity, mortality, and exposes the public to unnecessary risks of poor sanitation. On the side of service providers, the inefficient and ineffective services are the main causes of poor performance rating and lower profit growth. Despite the growing consequences and increasing impressive literatures on the cost-and-effect of ER overcrowding, the suggested programs of decongesting the emergency room or expanding the healthcare units and facilities to accommodate the growing number of patients is poorly understood by stakeholders. It is however true to state that ER overcrowding and its consequences are not well defined in most emergency medical literatures since they are considered internal issues that the healthcare management can handle. This paper suggests certain managerial solutions to ER overcrowding for the purposes of improving service delivery and increasing profit level.
Before giving managerial solutions to ER overcrowding, it is always prudent to have insight into some of the major causes of ER overcrowding. The most common causes of ER overcrowding according to this case include insufficient beds for patients admitted at the hospital, shortage of nursing staff, increased complexities and acuity of patients in ER, and increasing volume of patients.
To reduce the overcrowding effects resulting from insufficient beds to accommodate the patients, the management can either reduce the number of patients or increase the capacity of beds to accommodate the inpatients and those in critical care conditions. The decision to increase bed capacity is optimal since most overcrowding cases result from shortages of inpatient beds and not emergency room capacity. This solution is based on the understanding that when a healthcare unit has enough bed capacity to meet the needs of patients, issues of overcrowding will not occur. In addition to increasing the number of acute and long-term care beds, the beds must also be better managed within the respective hospitals.
Apart from expanding bed capacity, the management can decide to expand its supply of emergency personnel to reduce the negative effects of understaffing. This will include an expansion of full-time position for emergency personnel and medical practitioners across the health facilities. Most hospitals face threat of part-time and casual skill retention, which at some points impede clinical judgement and ability to perform as part of the resuscitative nursing team. In the supply process, the management must ensure adequate assessment and resuscitative knowledge as provided by the clinical nurse educator for the purpose of maintaining high levels of competency. The management must at all times work on recruitment development and retention initiatives for the emergency physicians. This is because the industry is currently experiencing shortages of trained emergency physicians.
It is also important for the management to expand its information systems and acquire some of the most current developments, especially with public health policy. The decision to expand informatics results from the inefficiencies of media reports, which cannot provide measurable data to characterize the magnitude of problems healthcare units are currently facing.
In general, system efficiency and effectiveness is highly valued by most healthcare providers. Giving management and patients’ service provision a technological approach can reduce overcrowding within emergency rooms. With the inclusion of technology, there is a possibility that the time taken to service one patient will reduce while the number of patients served within that time range will increase.