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• W2168667605 abstract "In 2006 the Institute of Medicine put the spotlight on a weak link in the US health care system—emergency care. 1 Institute of Medicine Hospital-based emergency care: at the breaking point. http://www.iom.edu/Reports/2006/Hospital-Based-Emergency-Care-At-the-Breaking-Point.aspx Google Scholar Faced with increased demand for both routine and emergency medical services, as well as a myriad of scheduling challenges, emergency departments have long been synonymous with overcrowding, long waiting times, and boarding of patients, who are held in the emergency department for long periods until an inpatient bed becomes available. The complexity and negative consequences of ED overcrowding and boarding are well documented 2 Hoot NR Aronsky D Review of emergency department crowding: causes, effects, and solutions. Ann Emerg Med. 2008; 52: 127-136 Google Scholar : disability and death from delayed diagnosis and intervention, 3 Pines JM Hollander JE Localio AR et al. The association between emergency department crowding and hospital performance on antibiotic timing for pneumonia and percutaneous intervention for myocardial infarction. Acad Emerg Med. 2006; 13: 873-878 Crossref PubMed Google Scholar , 4 Pines JM Hollander JE Association between cardiovascular complications and ED crowding. Paper presented at: American College of Emergency Physicians 2007 Scientific Assembly; October 8-11; Seattle, WA2007 Google Scholar increased total length of stay (LOS) in patients boarded in the emergency department, 5 Richardson DB The access-block effect: relationship between delay to reaching an inpatient bed and inpatient length of stay. Med J Aust. 2002; 177: 492-495 PubMed Google Scholar , 6 Liew D Liew D Kennedy MP Emergency department length of stay independently predicts excess inpatient length of stay. Med J Aust. 2003; 179: 524-526 PubMed Google Scholar sick patients who leave the emergency department without care 7 Weiss SJ Ernst AA Derlet R et al. Relationship between the national ED overcrowding scale and the number of patients who leave without being seen in an academic ED. Am J Emerg Med. 2005; 23: 288-294 Abstract Full Text Full Text PDF PubMed Scopus (123) Google Scholar and later require admission, 8 Richardson DB Bryant M Confirmation of association between overcrowding and adverse events in patients who do not wait to be seen. Acad Emerg Med. 2004; 11: 462 Google Scholar increased medical errors, 9 Cowan RM Trzeciak S Clinical review: emergency department overcrowding and the potential impact on the critically ill. Crit Care. 2005; 9: 291-295 Crossref PubMed Scopus (197) Google Scholar increased risk of death, 10 Lie SW Thomas SH Gordon JA Weissman J Frequency of adverse events and errors among patients boarding in the emergency department. Acad Emerg Med. 2005; 12: 49-50 Crossref Google Scholar , 11 Sprivulis PC DaSilva JA Jacobs IG Frazer ARL Jelinek GA The association between hospital overcrowding and mortality among patients admitted via Western Australian emergency departments. Med J Aust. 2006; 184: 208-212 PubMed Google Scholar , 12 Richardson DB Increase in patient mortality at 10 days associated with emergency department overcrowding. Med J Aust. 2006; 184: 213-216 PubMed Google Scholar ambulance diversion, 13 Burt CW McCaig CW Valverde RH Analysis of ambulance transports and diversions among emergency departments. Ann Emerg Med. 2006; 47: 317-326 Abstract Full Text Full Text PDF PubMed Scopus (167) Google Scholar and increased risk of physician malpractice. 1 Institute of Medicine Hospital-based emergency care: at the breaking point. http://www.iom.edu/Reports/2006/Hospital-Based-Emergency-Care-At-the-Breaking-Point.aspx Google Scholar Regina M. Ciambrone, Member, West Central Jersey Chapter of NJENA, is Director, Emergency Services, Robert Wood Johnson University Hospital, New Brunswick, NJ. Kathleen E. Zavotsky, Member, West Central Jersey Chapter of NJENA, is Clinical Nurse Specialist, Emergency Services, Robert Wood Johnson University Hospital, New Brunswick, NJ. Keeba Souto is Nurse Manager, Pediatric Emergency Department, Robert Wood Johnson University Hospital, New Brunswick, NJ. Katherine Baron is Head Nurse, Adult Emergency Department, Robert Wood Johnson University Hospital, New Brunswick, NJ. Vincent D. Joseph is Executive Vice President and Chief Operating Officer, Robert Wood Johnson University Hospital, New Brunswick, NJ. Joyce E. Johnson is Senior Vice President and Chief Nursing Officer, Robert Wood Johnson Hospital, and Associate Dean, Rutgers University School of Nursing, New Brunswick, NJ. Kari A. Mastro is Assistant Vice President, Nursing, Robert Wood Johnson University Hospital, New Brunswick, NJ." @default.
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• W2168667605 date "2012-11-01" @default.
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• W2168667605 title "Redesign of an Urban Academic Emergency Department: Action Research Can Make a Difference" @default.
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• W2168667605 doi "https://doi.org/10.1016/j.jen.2011.11.001" @default.
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