title: Frequency, determinants and impact of overcrowding in emergency departments in Canada: a national survey.
abstract: Several reports have documented the prevalence and severity of emergency department (ED) overcrowding at specific hospitals or cities in Canada; however, no study has examined the issue at a national level. A 54-item, self-administered, postal and web-based questionnaire was distributed to 243 ED directors in Canada to collect data on the frequency, impact and factors associated with ED overcrowding. The survey was completed by 158 (65% response rate) ED directors, 62% of whom reported overcrowding as a major or severe problem during the past year. Directors attributed overcrowding to a variety of issues including a lack of admitting beds (85%), lack of acute care beds (74%) and the increased length of stay of admitted patients in the ED (63%). They perceived ED overcrowding to have a major impact on increasing stress among nurses (82%), ED wait times (79%) and the boarding of admitted patients in the ED while waiting for beds (67%). Overcrowding is not limited to large urban centres; nor is it limited to academic and teaching hospitals. The perspective of ED directors reinforces the need for further examination of effective policies and interventions to reduce ED overcrowding.
authors.affiliation: Capital Health/University of Alberta Evidence-Based Practice Center, Edmonton.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Bond
authors.forename: Maria B
authors.initials: MB
authors.lastname: Ospina
authors.forename: Sandra
authors.initials: S
authors.lastname: Blitz
authors.forename: Marc
authors.initials: M
authors.lastname: Afilalo
authors.forename: Sam G
authors.initials: SG
authors.lastname: Campbell
authors.forename: Michael
authors.initials: M
authors.lastname: Bullard
authors.forename: Grant
authors.initials: G
authors.lastname: Innes
authors.forename: Brian
authors.initials: B
authors.lastname: Holroyd
authors.forename: Gil
authors.initials: G
authors.lastname: Curry
authors.forename: Michael
authors.initials: M
authors.lastname: Schull
authors.forename: Brian H
authors.initials: BH
authors.lastname: Rowe
mesh_terms: D002170:Canada; D003441:Crowding; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D019538:Health Care Surveys; D006801:Humans; D009313:National Health Programs