What should be the response of EDs to overcrowding?
The Crowding Resources Task Force of the American College of Emergency Physicians developed recommendations for short- and long-term solutions to ED overcrowding.(13) At the emergency department level, best practices to address overcrowding include: real-time monitoring of ED crowding metrics with the goal to identify problems before they get out of control; using written triage protocols; having flexible ED and triage staffing that allow for adjustment of staffing as needed; automating processes where possible (eg, using patient tracking software); and expanding fast-track and observation services. In the end, of course, these measures must be placed in the context of the broader health care environment. The systemic problems that lead to ED overcrowding (such as the nursing shortage and the barriers to primary care for some patients) must also be addressed. Otherwise, even EDs that thoughtfully implement triage strategies and protocols are likely to be overwhelmed by the magnitude of
