title: Assigning residents of emergency medicine to screen patients before admission: a strategy to overcome overcrowding.
abstract: BACKGROUND
  The overcrowded hospital is an unsafe one. Overcrowding the emergency department (ED) results in increased patient suffering, prolonged waiting time, deteriorating level of service, and on occasion, a worsened medical condition or even death.
  
  
  OBJECTIVE
  This study proposes a strategy to overcome ED overcrowding.
  
  
  METHODS
  The proportion of acute area admitted patients to screened patients (A/S), and the proportion of patients who were finally transferred to inpatient wards (W/A) to those admitted in ED acute area were investigated during 6 consecutive months. Emergency medicine residents were assigned to screen patients before ED admission and afterwards.
  
  
  RESULTS
  The average A/S changed from 82.4% to 44.2% (P = 0.028), and the average W/A changed from 28.3% to 51.48% (P = 0.028) before and after screening patients respectively. The initiative resulted in 97 less patients in the acute area per day.
  
  
  CONCLUSIONS
  Decreased number of acute area admitted patients, and increase W/A proportion showed that the initiative was successful in obviating ED overcrowding while provision of care to those most in need was not altered.
authors.affiliation: Department of Emergency Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Javadzadeh
authors.affiliation: Department of Emergency Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Davoudi
authors.affiliation: Department of Community Medicine, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Farnoush
authors.initials: F
authors.lastname: Davoudi
authors.affiliation: Department of Emergency Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors.forename: Sadrollah
authors.initials: S
authors.lastname: Mahmoodi
authors.affiliation: Department of Emergency Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Ghane
authors.affiliation: Department of Emergency Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors.forename: Hasan
authors.initials: H
authors.lastname: Goodarzi
authors.affiliation: Department of Emergency Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Faraji
keywords: Emergency Services; Intervention
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