Assigning Residents of Emergency Medicine to Screen Patients Before Admission: a Strategy to Overcome Overcrowding

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. Objectives: This study proposes a strategy to overcome ED overcrowding. Materials and 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 ۶ consecutive months. Emergency medicine residents were assigned to screen patients before ED admission and afterwards. Results: The average A/S changed from ۸۲.۴% to ۴۴.۲% (P = ۰.۰۲۸), and the average W/A changed from ۲۸.۳% to ۵۱.۴۸% (P = ۰.۰۲۸) before and after screening patients respectively. The initiative resulted in ۹۷ 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.