CADTH Health Technology Review Guidance - Emergency Department Overcrowding in Canada

Overcrowding in the ED arises when 67 the demand for health services in the ED exceeds the capacity of the health system—including the ED, hospital and community—to 68 provide quality care in a reasonable amount of time.1,2 People visit the ED for legitimate health care needs that cannot be met 69 elsewhere, which materializes as ED overcrowding and an expanded scope of practice for ED clinicians. [...] CADTH HEALTH TECHNOLOGY REVIEW GUIDANCE Emergency Department Overcrowding in Canada 6 216 o The specific contributors to overcrowding are relatively unique to each ED, hospital, and corresponding health region, 217 given the complex nature of the problem and health and social systems, and the effect of local contexts on the 218 interrelationships between the many interacting and contributing under. [...] 236 o Input factors, such as characteristics of the population the ED is intended to serve, patient arrival patterns, availability 237 of primary care, access to diagnostic services in the community outside the ED, and access to ambulatory care and 238 specialist care services in the community. [...] This 260 involves consideration of available resources and infrastructure, support and leadership from all relevant health system partners, 261 an analysis of local and health system data and metrics, and perspectives of those who work in and use the ED and hospital to 262 reflect whether and how the intervention may work in the local context. [...] 365 Qualitative Review: Perspectives and Experiences Regarding the Impacts of Emergency 366 Department Overcrowding 367 A review was undertaken of qualitative studies on how people who engage with ED services experience and understand the impacts 368 of ED overcrowding on quality of care, patient safety, and the well-being of health care professional learners and staff working in the 369 ED.