文章基本信息

标题：Solving the worldwide emergency department crowding problem – what can we learn from an Israeli ED?
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作者：Jesse M. Pines ; Steven L. Bernstein
期刊名称：Israel Journal of Health Policy Research
印刷版ISSN：2045-4015
电子版ISSN：2045-4015
出版年度：2015
卷号：4
期号：1
页码：52
DOI：10.1186/s13584-015-0049-0
语种：English
出版社：BioMed Central
摘要：ED crowding is a prevalent and important issue facing hospitals in Israel and around the world, including North and South America, Europe, Australia, Asia and Africa. ED crowding is associated with poorer quality of care and poorer health outcomes, along with extended waits for care. Crowding is caused by a periodic mismatch between the supply of ED and hospital resources and the demand for patient care. In a recent article in the Israel Journal of Health Policy Research, Bashkin et al. present an Ishikawa diagram describing several factors related to longer length of stay (LOS), and higher levels of ED crowding, including management, process, environmental, human factors, and resource issues. Several solutions exist to reduce ED crowding, which involve addressing several of the issues identified by Bashkin et al. This includes reducing the demand for and variation in care, and better matching the supply of resources to demands in care in real time. However, what is needed to reduce crowding is an institutional imperative from senior leadership, implemented by engaged ED and hospital leadership with multi-disciplinary cross-unit collaboration, sufficient resources to implement effective interventions, access to data, and a sustained commitment over time. This may move the culture of a hospital to facilitate improved flow within and across units and ultimately improve quality and safety over the long-term.
关键词：Emergency Department ; Emergency Department Provider ; Emergency Department Crowding ; Ishikawa Diagram ; Daily Emergency Department