Emergency Room Overcrowding

Session Resources

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Related CHSRF article

Myth: Emergency room overcrowding is caused by non-urgent cases

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October 14, 2009
12:00 p.m. - 12:45 p.m. EDT
Call in English only

There are many reasons why ERs across Canada are crowded - and even more ideas about why this is the case. Understanding the issue is helped by considering who is using emergency departments, how patients move through them and how quickly patients who need more care can proceed from the ER to their next point of care.

Key questions addressed by this Researcher on Call:

  1. Do patients who have more frequent ER visits tend to have more or fewer contacts with other health care personnel including primary care and other types of specialist physicians?
  2. How much do factors such as patient volume (overall and low acuity patients), ER throughput (e.g. traditional triage and diagnostic processes) and output procedures (e.g. admissions to hospital) contribute to ER overcrowding?
  3. What additional evidence is most essential to further define the determinants of ER use and overcrowding?

Featured Speakers

Dr. Malcolm Doupe is an assistant professor in the Faculty of Medicine, University of Manitoba, and is a senior research scientist at the Manitoba Centre for Health Policy, University of Manitoba.

He is an expert in conducting healthcare services research with a particular emphasis on nursing homes (defining use patterns, measuring quality care) and emergency departments (characterizing frequent users).

Dr. Ricardo Lobato de Faria is the Medical Director of the Winnipeg Regional Health Authority (WRHA) Emergency Program and the University of Manitoba Emergency Department.

He is also the provincial advisor to Manitoba Minister of Health on Emergency Care; Chief Medical Officer, Seven Oaks General Hospital (WRHA); and the Site Medical Manager for Emergency Medicine at the Seven Oaks General Hospital. Dr. Lobato de Faria has both research and clinical expertise related to optimizing patient flow in a variety of healthcare settings, including emergency departments.

André Maddison is an M.Sc. student in Community Health and Epidemiology at Dalhousie University and is an alumnus of Wilfrid Laurier University.

His M.Sc. thesis, under the supervision of Yukiko Asada, is examining equity in access to adjuvant and palliative radiotherapy in Nova Scotia. Mr. Maddison is a student trainee with the CIHR-funded project Towards Improving Access to Colorectal Cancer Services in Nova Scotia (Principle investigator: Dr. Eva Grunfeld) and the Network for End of Life Care (Co-primary investigators: Dr. Fred Burge and Dr. Grace Johnston). He was also awarded a Canadian Health Services Research Foundation's Mythbusters Award in 2009 for his article, "Myth: Patients with non-urgent care needs overcrowd and block access to emergency care." This article will be published in CHSRF's Mythbuster series in October of 2009.

Readings of interest

  1. Asplin, B. R., et al. "A conceptual model of emergency department crowding." Ann Emerg.Med 42.2 (2003): 173-80
  2. Chan, B. T. and H. J. Ovens. "Frequent users of emergency departments. Do they also use family physicians' services?" Can Fam.Physician 48 (2002): 1654-60.
  3. Doupe, M., Kozyrskyj, A., Soodeen R.A., Derksen, S., Burchill, C., & Huq S. An Initial Analysis of Emergency Departments and Urgent Care in Winnipeg. Winnipeg, Manitoba Centre for Health Policy, May 2008. (Participants are encouraged to focus on chapter 8)
  4. Hostetler, M. A., et al. "Emergency department overcrowding and children." Pediatr.Emerg.Care. 23.7 (2007): 507-15.
  5. Schull, M. J., A. Kiss, & J. P. Szalai. "The Effect of Low-Complexity Patients on Emergency Department Waiting Times." Ann Emerg.Med (2006).

For more information, please contact roc-csa@chsrf.ca or 613-728-2238 ext. 221.