title: Overcrowding in emergency department: an international issue.
abstract: Overcrowding in the emergency department (ED) has become an increasingly significant worldwide public health problem in the last decade. It is a consequence of simultaneous increasing demand for health care and a deficit in available hospital beds and ED beds, as for example it occurs in mass casualty incidents, but also in other conditions causing a shortage of hospital beds. In Italy in the last 12-15 years, there has been a huge increase in the activity of the ED, and several possible interventions, with specific organizational procedures, have been proposed. In 2004 in the United Kingdom, the rule that 98 % of ED patients should be seen and then admitted or discharged within 4 h of presentation to the ED ('4 h rule') was introduced, and it has been shown to be very effective in decreasing ED crowding, and has led to the development of further acute care clinical indicators. This manuscript represents a synopsis of the lectures on overcrowding problems in the ED of the Third Italian GREAT Network Congress, held in Rome, 15-19 October 2012, and hopefully, they may provide valuable contributions in the understanding of ED crowding solutions.
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine and Psychology, Medical-Surgery Sciences and Translational Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035-1039, 00189, Rome, Italy, salvatore.disomma@uniroma1.it.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Di Somma
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Paladino
authors.forename: Louella
authors.initials: L
authors.lastname: Vaughan
authors.forename: Irene
authors.initials: I
authors.lastname: Lalle
authors.forename: Laura
authors.initials: L
authors.lastname: Magrini
authors.forename: Massimo
authors.initials: M
authors.lastname: Magnanti
mesh_terms: D001509:Bed Occupancy / Q000191:economics; D003365:Costs and Cost Analysis; D003441:Crowding; D003695:Delivery of Health Care / Q000191:economics / Q000379:methods; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data* / Q000639:trends*; D006801:Humans; D038622:Internationality; D009936:Organizational Innovation; D013997:Time Factors