Improved patient pathways can prevent overcrowding
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Improved patient pathways can prevent overcrowding

Russell Emeny Director, NHS Interim Management and Support urgent and emergency care intensive support team
Vincent Connolly Consultant physician, James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough

Russell Emeny and Vincent Connolly set out eight principles that trusts should adopt to ensure emergency departments and hospitals do not become overwhelmed by demand

Emergency department (ED) crowding is a common problem throughout the western world. Not only does crowding create a miserable environment for patients, and to considerable stress and poor job satisfaction among staff, it can also lead EDs to breach the four-hour standard and other care quality indicators. In addition, crowding in EDs correlates with increases in patient mortality, rates of admission, lengths of inpatient stay and costs. This article argues that crowding is best tackled by the consistent application of eight principles, derived from various guidance, to emergency patient pathways, particularly those in acute settings.

Emergency Nurse. 20, 10, 20-24. doi: 10.7748/en2013.


Peer review

This article has been subject to double blind peer review

Conflict of interest

None declared

Received: 21 January 2013

Accepted: 07 February 2013

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