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Journal articles on the topic 'Hospital overcrowding'

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Published: 10 December 2022
Last updated: 28 January 2023

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1

Mishra, S. "Hospital overcrowding." Western Journal of Medicine 174, no. 3 (March 1, 2001): 170. http://dx.doi.org/10.1136/ewjm.174.3.170.

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2

AMERICANCOLLEGEOFEMERGENCYPHY. "Hospital and emergency department overcrowding." Annals of Emergency Medicine 19, no. 3 (March 1990): 336. http://dx.doi.org/10.1016/s0196-0644(05)82059-1.

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3

Robakowska, Marlena, Anna Tyrańska-Fobke, Daniel Ślęzak, Michał Rogowski, Andrzej Basiński, and Sylwia Jałtuszewska. "Increased demand for services provided in hospital emergency departments." Emergency Medical Service 9, no. 1 (2022): 43–47. http://dx.doi.org/10.36740/emems202201107.

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Increase in demand for health services in HED (Hospital Emergency Department) and their increasing this greater overcrowding is known from the English language as overcrowding. The concept of overcrowding is also inherently related to the notion of frequent use of assistance in the SOR. However, no uniform criterion for defining this concept has been developed so far. The aim of this study is to present the causes of the phenomenon of overcrowding and the related issues of patients’ functioning in the health care system. The main reasons for this phenomenon are the demographic aspect, i.e. the extension of the average age of many societies, but also the tendency of patients to omit medical assistance at the primary health care level and go directly to the HED as facilities with greater diagnostic and therapeutic possibilities. The consequences of the overcrowding phenomenon are, above all, an increase in the costs of HED functioning, longer waiting times for health services provided in the HED and excessive workload of the staff employed there. Currently, overcrowding has been recognized as a global public health problem.
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Cameron, Peter A. "Hospital overcrowding: a threat to patient safety?" Medical Journal of Australia 184, no. 5 (March 2006): 203–4. http://dx.doi.org/10.5694/j.1326-5377.2006.tb00200.x.

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Virtanen, Marianna, Jussi Vahtera, G. David Batty, Katinka Tuisku, Jaana Pentti, Tuula Oksanen, Paula Salo, Kirsi Ahola, and Mika Kivimäki. "Overcrowding in psychiatric wards and physical assaults on staff: data-linked longitudinal study." British Journal of Psychiatry 198, no. 2 (February 2011): 149–55. http://dx.doi.org/10.1192/bjp.bp.110.082388.

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BackgroundPatient overcrowding and violent assaults by patients are two major problems in psychiatric healthcare. However, evidence of an association between overcrowding and aggressive behaviour among patients is mixed and limited to small-scale studies.AimsThis study examined the association between ward overcrowding and violent physical assaults in acute-care psychiatric in-patient hospital wards.MethodLongitudinal study using ward-level monthly records of bed occupancy and staff reports of the timing of violent acts during a 5-month period in 90 in-patient wards in 13 acute psychiatric hospitals in Finland. In total 1098 employees (physicians, ward head nurses, registered nurses, licensed practical nurses) participated in the study. The outcome measure was staff reports of the timing of physical assaults on both themselves and ward property.ResultsWe found that 46% of hospital staff were working in overcrowded wards, as indicated by >10 percentage units of excess bed occupancy, whereas only 30% of hospital personnel were working in a ward with no excess occupancy. An excess bed occupancy rate of >10 percentage units at the time of an event was associated with violent assaults towards employees (odds ratio (OR) = 1.72, 95% CI 1.05–2.80; OR = 3.04, 95% CI 1.51–6.13 in adult wards) after adjustment for confounding factors. No association was found with assaults on ward property (OR = 1.06, 95% CI 0.75–1.50).ConclusionsThese findings suggest that patient overcrowding is highly prevalent in psychiatric hospitals and, importantly, may increase the risk of violence directed at staff.
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6

Hou, Wanxin, Shaowen Qin, and Campbell Henry Thompson. "Effective Response to Hospital Congestion Scenarios: Simulation-Based Evaluation of Decongestion Interventions." International Journal of Environmental Research and Public Health 19, no. 23 (December 6, 2022): 16348. http://dx.doi.org/10.3390/ijerph192316348.

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Hospital overcrowding is becoming a major concern in the modern era due to the increasing demand for hospital services. This study seeks to identify effective and efficient ways to resolve the serious problem of congestion in hospitals by testing a range of decongestion strategies with simulated scenarios. In order to determine more efficient solutions, interventions with smaller changes were consistently tested at the beginning through a simulation platform. In addition, the implementation patterns were investigated, which are important to hospital managers with respect to the decisions made to control hospital congestion. The results indicated that diverting a small number of ambulances seems to be more effective and efficient in congestion reduction compared to other approaches. Furthermore, instead of implementing an isolated approach continuously, combining one approach with other strategies is recommended as a method for dealing with hospital overcrowding.
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Savioli, Gabriele, Iride Francesca Ceresa, Nicole Gri, Gaia Bavestrello Piccini, Yaroslava Longhitano, Christian Zanza, Andrea Piccioni, Ciro Esposito, Giovanni Ricevuti, and Maria Antonietta Bressan. "Emergency Department Overcrowding: Understanding the Factors to Find Corresponding Solutions." Journal of Personalized Medicine 12, no. 2 (February 14, 2022): 279. http://dx.doi.org/10.3390/jpm12020279.

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It is certain and established that overcrowding represents one of the main problems that has been affecting global health and the functioning of the healthcare system in the last decades, and this is especially true for the emergency department (ED). Since 1980, overcrowding has been identified as one of the main factors limiting correct, timely, and efficient hospital care. The more recent COVID-19 pandemic contributed to the accentuation of this phenomenon, which was already well known and of international interest. Considering what would appear to be a trivial definition of overcrowding, it may seem simple for the reader to hypothesize solutions for what seems to be one of the most avoidable problems affecting the hospital system. However, proposing solutions to overcrowding, as well as their implementation, cannot be separated from a correct and precise definition of the issue, which must consider the main causes and aggravating factors. In light of the need of finding solutions that can put an end to hospital overcrowding, this review aims, through a review of the literature, to summarize the triggering factors, as well as the possible solutions that can be proposed.
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8

Kondro, Wayne. "Hospital overcrowding forces Canda to boost healthcare spending." Lancet 353, no. 9153 (February 1999): 653. http://dx.doi.org/10.1016/s0140-6736(05)75453-2.

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9

Simmons, Florence M. "CEU: Hospital overcrowding: An opportunity for case managers." Case Manager 16, no. 4 (July 2005): 52–54. http://dx.doi.org/10.1016/j.casemgr.2005.06.004.

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10

Hoyle, Lisa. "Condition Yellow: A Hospital-Wide Approach to ED Overcrowding." Journal of Emergency Nursing 39, no. 1 (January 2013): 40–45. http://dx.doi.org/10.1016/j.jen.2011.07.020.

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11

Khanna, Sankalp, Justin Boyle, and Kathryn Zeitz. "Using capacity alert calls to reduce overcrowding in a major public hospital." Australian Health Review 38, no. 3 (2014): 318. http://dx.doi.org/10.1071/ah13103.

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Objective To investigate the efficacy of capacity alert calls in reducing acute hospital overcrowding through addressing rising occupancy, high patient throughput and increased access block. Methods Retrospective analysis of 24 months of in-patient, emergency department, and capacity alert call log data from a large metropolitan public hospital in Australia. The analysis explored statistical differences in patient flow parameters between capacity alert call days and other days including a control case set of days with statistically similar levels of occupancy. Results The study identified a significant (P < 0.05) reduction in occupancy, patient throughput and access block on capacity alert call days. Capacity alert call days reversed rising occupancy trends, with 6 out of 7 flow parameters reporting significant improvement (P < 0.05) over the 48 h following the call. Only 3 of these 7 flow parameters were significantly improved 48 h after control case days, confirming value in the alert mechanism and that the results are not a regression toward the mean phenomenon. Conclusions Escalation processes that alert and engage the whole hospital in tackling overcrowding can successfully deliver sustained improvements in occupancy, patient throughput and access block. The findings support and validate the use of capacity alert escalation calls to manage overcrowding, but suggest the need to improve the consistency of trigger mechanisms and the efficiency of the processes initiated by the capacity alert call. What is known about the topic? Hospitals use various capacity management protocols to combat rising occupancy and the resulting poor patient care outcomes. However, there is little or no empirical evidence based on real hospital data to validate the efficacy of these approaches. What does this paper add? This study suggests that capacity alert call days result in a significant reduction in occupancy, throughput and access block, thereby arresting and reversing rising occupancy trends and returning a greater improvement in patient flow parameters over the following 48 h than is observed on a set of control case days with statistically similar levels of occupancy. The study also identifies aspects of the protocol in need of improvement. What are the implications for practitioners? The study provides valuable insight into the ability of capacity alert calls to tackle rising occupancy and reduce overcrowding in hospitals. It makes a good case for hospitals to conduct similar reviews of their capacity management protocols to help identify and address suboptimal aspects of the protocols to support delivery of improved patient flow and better patient outcomes.
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Taype-Huamaní, Waldo, Lino Castro-Coronado, Delcio Miranda-Soler, and Jose Amado Tineo. "Saturación y hacinamiento del servicio de emergencia de un hospital urbano." Revista de la Facultad de Medicina Humana 20, no. 2 (March 27, 2020): 44–49. http://dx.doi.org/10.25176/rfmh.v20i2.2709.

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13

Schull, Michael J., Pamela M. Slaughter, and Donald A. Redelmeier. "Urban emergency department overcrowding: defining the problem and eliminating misconceptions." CJEM 4, no. 02 (March 2002): 76–83. http://dx.doi.org/10.1017/s1481803500006163.

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ABSTRACTStudy objective:To develop an operational definition and a parsimonious list of postulated determinants for urban emergency department (ED) overcrowding.Methods:A panel was formed from clinical and administrative experts in pre-hospital, ED and hospital domains. Key studies and reports were reviewed in advance by panel members, an experienced health services researcher facilitated the panel’s discussions, and a formal content analysis of audiotaped recordings was conducted.Results:The panel considered community, patient, ED and hospital determinants of overcrowding. Of 46 factors postulated in the literature, 21 were not retained by the experts as potentially important determinants of overcrowding. Factors not retained included access to primary care services and seasonal influenza outbreaks. Key determinants retained included admitted patients awaiting beds and patient characteristics. Ambulance diversion was considered to be an appropriate operational definition and proxy measure of ED overcrowding.Conclusion:These results help to clarify the conceptual framework around ED overcrowding, and may provide a guide for future research. The relative importance of the determinants must be assessed by prospective studies.
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14

Menec, Verena H., Noralou P. Roos, and Leonard MacWilliam. "Seasonal Patterns of Hospital Use in Winnipeg: Implications for Managing Winter Bed Crises." Healthcare Management Forum 15, no. 4_suppl (December 2002): 58–64. http://dx.doi.org/10.1016/s0840-4704(10)60184-6.

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This study examined whether Winnipeg hospitals experience predictable “high-volume periods” in order to determine whether hospital overcrowding might be anticipated and, therefore, avoided. We found that high-volume periods among medical patients occurred during all but one year between 1987 and 1998. Most high-volume periods occurred during influenza seasons. Preventing such recurrent bed pressures requires a multi-faceted approach, involving preventive efforts to reduce hospital admissions (influenza vaccination) and alternatives to managing the hospital system.
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Bhandari, Sundeep. "Lessons Learnt from a Pneumonia Outbreak in a Naval Training Establishment." Epidemiology International 07, no. 02 (September 7, 2022): 1–5. http://dx.doi.org/10.24321/2455.7048.202204.

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Introduction: In August 2014, an unusually large number of cases of pneumonia was reported from amongst Naval Recruits in a Naval Training Establishment by the co-located Indian Naval Hospital Ship. Material and Methods: The study was descriptive observational (retrospective) in nature, which was carried out at Indian Naval Training Establishment and Indian Naval Hospital Ship. The following information was collected: (a) Batch-wise comparison of data of recruits at Indian Naval Training establishment (where two major batches undergo training every year) was done for the occurrence year (2014) and the preceding 03 years i.e 2011, 2012 and 2013. Further, data on cases of pneumonia was collected from Indian Naval Hospital Ship as recorded by the hospital for last 03 years (2011, 2012 & 2013) and the year 2014, using an epidemiological format. Results: (a) Overcrowding. (b) Confirmation of existence of Outbreak. (c) Distribution of cases as per symptomatology and X-ray findings. (d) Manmade overcrowding, physical and psychological stress of military training exposes non-immune persons to several pathogens. The study confirms overcrowding with per capita standard for floor space and air space being 5 sqm and 18 m 3. The recommended distance between two adjacent beds is 1.8m 1 Infact, they were even below the standard of 4 sqm recommended by WHO 4. A positive Correlation is known to exist between overcrowding and incidence of pneumonia 5. Conclusion: Batch-wise comparison of cases and incidence of LRTI/ Pneumonia confirmed the outbreak. Further, there were no cases of Pneumonia amongst training staff (officers & sailors) and other civilian in adjoining areas. Consequent to increase in induction pattern at Naval Training Establishment, coupled with absence of accompanying increase. Consequently, analysis of living conditions established that overcrowding existed in dormitories, dining areas and all facilities related to training.
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Virtanen, Marianna, Jaana Pentti, Jussi Vahtera, Jane E. Ferrie, Stephen A. Stansfeld, Hans Helenius, Marko Elovainio, et al. "Overcrowding in Hospital Wards as a Predictor of Antidepressant Treatment Among Hospital Staff." American Journal of Psychiatry 165, no. 11 (November 2008): 1482–86. http://dx.doi.org/10.1176/appi.ajp.2008.07121929.

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17

Bose, Anjana, and Agniva Ghosh Dastidar. "Do surgical patients of remote areas really need to overburden urban medical colleges: a practical survey analysis." International Surgery Journal 6, no. 2 (January 28, 2019): 564. http://dx.doi.org/10.18203/2349-2902.isj20190404.

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Background: Public health care delivery is inadequate and as a result the demand supply gap is large, this is specially so in rural India. Even with so many hospitals in the peripheries still there is overcrowding in the urban Medical Colleges. Overcrowding is when hospitals operate beyond a safe level of 85% bed occupancy. This leads to delay in treatment and subsequent medical complications. Furthermore, quality of the treatment is jeopardised as its effects physician’s effectiveness, causing frustration among medical staff and may even contribute to violence. The objective was to identify the elective/non-emergency operations that could have been done in rural hospitals but were done in a tertiary Medical College and to find out the cause for avoiding the local government hospitals nearer to their residence. This study suggested some remedies to correct this disparity.Methods: This was an observational and descriptive study where patient’s type of operation, distance travelled and cause for coming to an urban Medical College was noted.Results: Majority of the patients did not have any idea as to why they chose this hospital, other reasons are lack of infrastructure in their rural hospital, bad reputation, lack of cleanliness, malpractice by the hospital staff etc.Conclusions: Health care facilities in different locations should be based on utilization rates and also proper and efficient management of these established facilities should be done.
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Sukemi Kamto Sudibyo. "Implementasi Teknik Antrian Pengendalian Unit Rawat Inap Guna Peningkatan Kepuasan Pasien Dan Kualitas Layanan." Dinamika: Jurnal Manajemen Sosial Ekonomi 1, no. 1 (May 3, 2021): 26–35. http://dx.doi.org/10.51903/dinamika.v1i1.22.

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The emergency department that is connected to the inpatient room of the hospital always strives to provide the best service to patients. There are many obstacles in the effort to achieve quality service to patients due to when the inpatient room serves too many different patients based on age and certain indications of the incoming patient, the hospital will face the problem of limited capacity of human resources and supporting materials. so that it can cause the patient to be examined and treated for a limited time. If the increasing number of incoming patients will have an impact on hospitalization time, long waiting time and cause overcrowding of patients in the inpatient room which will certainly affect the level of patient satisfaction and quality of service.With the implementation of the queuing technique, the hospital was able to improve service and maximum patient satisfaction because the queuing technique was able to reduce hospitalization and waiting time so that it would not cause overcrowding of patients in the inpatient room in accordance with the capacity of the hospital's human and material resources.
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Richardson, D. B. "Validation of the Refined Overcrowding Scale in a Different Hospital." Academic Emergency Medicine 12, Supplement 1 (May 1, 2005): 22–23. http://dx.doi.org/10.1197/j.aem.2005.03.054.

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Bullard, M., B. Holroyd, K. Sochaki, and B. Rowe. "Emergency Department Overcrowding Inflation in a Tertiary Care Teaching Hospital." Academic Emergency Medicine 14, no. 5 Supplement 1 (May 1, 2007): S83—S84. http://dx.doi.org/10.1197/j.aem.2007.03.933.

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Virtanen, Marianna. "Patients With Infectious Diseases, Overcrowding, and Health in Hospital Staff." Archives of Internal Medicine 171, no. 14 (July 25, 2011): 1296. http://dx.doi.org/10.1001/archinternmed.2011.313.

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22

Schull, Michael J., John-Paul Szalai, Brian Schwartz, and Donald A. Redelmeier. "Emergency Department Overcrowding Following Systematic Hospital Restructuring Trends at Twenty Hospitals over Ten Years." Academic Emergency Medicine 8, no. 11 (November 2001): 1037–43. http://dx.doi.org/10.1111/j.1553-2712.2001.tb01112.x.

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23

Menec, Verena H., Sharon Bruce, and Leonard MacWilliam. "Exploring Reasons for Bed Pressures in Winnipeg Acute Care Hospitals." Canadian Journal on Aging / La Revue canadienne du vieillissement 24, S1 (2005): 121–31. http://dx.doi.org/10.1353/cja.2005.0051.

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ABSTRACTHospital overcrowding has plagued Winnipeg and other Canadian cities for years. This study explored factors related to overcrowding. Hospital files were used to examine patterns of hospital use from fiscal years 1996/1997 to 1999/2000. Chart reviews were conducted to examine appropriateness of admissions and hospital stays during one pressure week. Results indicate that pressure periods in the hospital system were driven by an influx of older adults with influenza-associated respiratory illnesses. Moreover, examination of one specific pressure week showed that at least 100 beds were occupied by patients who likely did not require acute care. The chart review revealed that a substantial proportion of non-acute patient-days were spent awaiting home care, long-term care, or diagnostic testing services. These findings suggest future bed pressures might be prevented through influenza vaccination and an increase in the availability of – and timely transfer to – alternative levels of care.
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Muhammad Nur Hidayah, Yanny Trisyani W, and Aan Nuraeni. "Overcrowding Factors in an Emergency Department: A Literature Review." Jurnal teknologi Kesehatan Borneo 1, no. 2 (December 3, 2020): 62–69. http://dx.doi.org/10.30602/jtkb.v1i2.18.

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The Emergency Department (ED) is an important department or unit and the core clinical unit of a hospital, which functions to receive, stabilize, and manage patients who need immediate emergency treatment, both in daily conditions and in disasters. Overcrowding in ED is a problem in many countries and is one cause of increased mortality and decreased quality of optimal health and nursing services in the world today, including in Indonesia. There has been little research on overcrowding factors in the ED. Many factors are thought to cause overcrowding. This literature review identifies factors that can influence overcrowding in the ED. The literature search was carried out on the electronic databases of Medline, PubMed, CINAHL, PsycInfo and the Cochrane Library with the keywords factors overcrowding, AND, ED crowding. The inclusion criteria consisted of overcrowding factors in the ED, Fulltext, and publishing from 2013 to 2019 in English. The assessment of the quality of the articles was carried out using instruments from CONSORT. The first search results found 5,026 articles, and after screening and evaluation, 3 articles met the inclusion criteria. The results of the literature review show that the many factors that influence the occurrence of overcrowding in the ED are categorized into three factors, namely input factors (increased number of patient visits), throughput factors (patient disposition and delay in diagnostic examination results), and output factors (access block, inability to transfer patients out of the emergency room to inpatient, lack of inpatient beds, entry rooms, and other resources).
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McDougal, Jr, Tom R., Stephen J. O'Connor, Amy Y. Landry, and Kristine R. Hearld. "Emergency Department wait time sharing: Do patients contribute to efficiency?" Journal of Hospital Administration 6, no. 4 (June 25, 2017): 23. http://dx.doi.org/10.5430/jha.v6n4p23.

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Objective: Inefficiency commonly results in overcrowding of the Emergency Department (ED) and is a problem for many hospitals. When a condition of overcrowding exists, it is often associated with lower patient satisfaction, lower care quality, and decreased financial position of the hospital. To improve patient throughput efficiency, hospitals use a variety of strategies including posting ED wait times on the hospital website and the use of ED reservation systems. This study investigates these two hospital strategies used to inform patients of anticipated wait times in the ED and their associations with patient throughput efficiency.Methods: The study employs bivariate and Ordinary Least Squares (OLS) regression models to explore the associations between ED efficiency, measured by time spent in the ED, and ED wait times posted on the hospital website (Wait Times on Website) and ED time efficiency and the use of ED reservation systems. The sample includes all 176 acute care hospitals with an ED located in Florida.Results: The results of this study support that posting ED wait times has a statistically significant association with time spent in the ED; however, we did not find an association between the use of a reservation system and time in the ED. Furthermore, the control variables of hospital licensed bed size, metropolitan location, percent of population without health insurance, and percent of population Medicaid eligible were found to have associations with time spent in the ED.Conclusions: This study supports that hospitals should inform patients of anticipated ED wait times. Methods to share wait times should include posting on the hospital website, billboards, or other means to increase the likelihood of informed patients. With anticipated wait time information, the patient has the opportunity to engage in rational decision making that will positively affect ED efficiency. Healthcare leaders, including hospital administrators and ED managers, are encouraged to identify and implement better ways to inform patients of hospital performance metrics to create the opportunity for greater patient decision engagement.
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Innes, Grant D., Marco L. A. Sivilotti, Howard Ovens, Kirstie McLelland, Adam Dukelow, Edmund Kwok, Anil Chopra, et al. "Emergency overcrowding and access block: A smaller problem than we think." CJEM 21, no. 2 (November 8, 2018): 177–85. http://dx.doi.org/10.1017/cem.2018.446.

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ABSTRACTObjectivesEmergency department (ED) access block, the inability to provide timely care for high acuity patients, is the leading safety concern in First World EDs. The main cause of ED access block ishospital access blockwith prolonged boarding of inpatients in emergency stretchers. Cumulative emergency access gap, the product of the number of arriving high acuity patients and their average delay to reach a care space, is a novel access measure that provides a facility-level estimate of total emergency care delays. Many health leaders believe these delays are too large to be solved without substantial increases in hospital capacity. Our objective was to quantify cumulative emergency access blocks (the problem) as a fraction of inpatient capacity (the potential solution) at a large sample of Canadian hospitals.MethodsIn this cross-sectional study, we collated 2015 administrative data from 25 Canadian hospitals summarizing patient inflow and delays to ED care space. Cumulative access gap for high acuity patients was calculated by multiplying the number of Canadian Triage Acuity Scale (CTAS) 1-3 patients by their average delay to reach a care space. We compared cumulative ED access gap to available inpatient bed hours to estimate fractional access gap.ResultsStudy sites included 16 tertiary and 9 community EDs in 12 cities, representing 1.79 million patient visits. Median ED census (interquartile range) was 66,300 visits per year (58,700-80,600). High acuity patients accounted for 70.7% of visits (60.9%-79.0%). The mean (SD) cumulative ED access gap was 46,000 stretcher hours per site per year (± 19,900), which was 1.14% (± 0.45%) of inpatient capacity.ConclusionED access gaps are large and jeopardize care for high acuity patients, but they are small relative to hospital operating capacity. If access block were viewed as a “whole hospital” problem, capacity or efficiency improvements in the range of 1% to 3% could profoundly mitigate emergency care delays.
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Trotzky, Daniel, Noaa Shopen, Jonathan Mosery, Neta Negri Galam, Yizhaq Mimran, Daniel Edward Fordham, Shiran Avisar, Aya Cohen, Malka Katz Shalhav, and Gal Pachys. "Real-time prediction of patient disposition and the impact of reporter confidence on mid-level triage accuracies: an observational study in Israel." BMJ Open 11, no. 12 (December 2021): e050026. http://dx.doi.org/10.1136/bmjopen-2021-050026.

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AimThe emergency department (ED) is the first port-of-call for most patients receiving hospital care and as such acts as a gatekeeper to the wards, directing patient flow through the hospital. ED overcrowding is a well-researched field and negatively affects patient outcome, staff well-being and hospital reputation. An accurate, real-time model capable of predicting ED overcrowding has obvious merit in a world becoming increasingly computational, although the complicated dynamics of the department have hindered international efforts to design such a model. Triage nurses’ assessments have been shown to be accurate predictors of patient disposition and could, therefore, be useful input for overcrowding and patient flow models.MethodsIn this study, we assess the prediction capabilities of triage nurses in a level 1 urban hospital in central Israeli. ED settings included both acute and ambulatory wings. Nurses were asked to predict admission or discharge for each patient over a 3-month period as well as exact admission destination. Prediction confidence was used as an optimisation variable.ResultTriage nurses accurately predicted whether the patient would be admitted or discharged in 77% of patients in the acute wing, rising to 88% when their prediction certainty was high. Accuracies were higher still for patients in the ambulatory wing. In particular, negative predictive values for admission were highly accurate at 90%, irrespective of area or certainty levels.ConclusionNurses prediction of disposition should be considered for input for real-time ED models.
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Richardson, Drew B., and David Mountain. "Myths versus facts in emergency department overcrowding and hospital access block." Medical Journal of Australia 190, no. 7 (April 2009): 369–74. http://dx.doi.org/10.5694/j.1326-5377.2009.tb02451.x.

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Brooks, Kathryn L., Jane S. Mulaik, Maggie P. Gilead, and Betty S. Daniels. "Patient overcrowding in psychiatric hospital units: Effects on seclusion and restraint." Administration and Policy in Mental Health 22, no. 2 (November 1994): 133–44. http://dx.doi.org/10.1007/bf02106547.

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Doxzon, Gillian, and Janet Howard-Ducsay. "ED Overcrowding: Successful Action Plans of a Southern California Community Hospital." Journal of Emergency Nursing 30, no. 4 (August 2004): 325–29. http://dx.doi.org/10.1016/j.jen.2004.06.009.

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31

Kirby, Sue E., Sarah M. Dennis, Upali W. Jayasinghe, and Mark F. Harris. "Frequent emergency attenders: is there a better way?" Australian Health Review 35, no. 4 (2011): 462. http://dx.doi.org/10.1071/ah10964.

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Background. Understanding the reasons for frequent re-attendances will assist in developing solutions to hospital overcrowding. This study aimed to identify the factors associated with frequent re-attendances in a regional hospital thereby highlighting possible solutions to the problem. Methods. A retrospective analysis was performed on emergency department data from 2008. Frequent re-attenders were defined as those with four or more presentations in a year. Clinical, service usage and demographic patient characteristics were examined for their influence on re-presentations using multivariate analysis. Results. A total of 8% of the total patients presenting to emergency re-attended four or more times in the year. Frequent re-attenders were older, presented with an unplanned returned visit and had a diagnosis of neurosis, chronic obstructive pulmonary disease (COPD), convulsions, dyspnoea or repeat prescriptions, follow-up examinations or dressings and sutures and less likely to present in summer. Frequent re-attendances were unrelated to sex, time of presentation or country of birth. Conclusions. Diversion of patients with minor conditions to alternative services; referral of COPD patients to follow-up respiratory services and patients with neurosis to community mental health services would reduce emergency utilisation. Improving access to and resourcing of alternative non-hospital services should be investigated to reduce emergency overcrowding. What is known about the topic? Frequent re-attendances at emergency contribute to emergency overcrowding and are a problem worldwide. Generally, frequent re-attendances have been associated with disadvantage. Identifying patient factors that predict re-attendances will assist in developing strategies to prevent their occurrence. The reasons for re-attendances may vary depending on access to other services and the role of the hospital. What does this paper add? This paper adds to the field by demonstrating how routinely collected hospital data can be used to determine patient characteristics important in frequent re-attendances. The factors associated with frequently re-attending patients include older age, type of condition, unplanned return visit and season. What are the implications for practitioners? This paper has implications for both administrators and clinicians. The diversion of attending patients with neurosis, COPD, dyspnoea or repeat prescriptions, follow-up examinations or dressings and sutures to alternative affordable and accessible services would reduce overcrowding in the emergency department.
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Braithwaite, Tricia, and Shanomae Rose. "Psychosocial Hazards faced by Healthcare Workers at a Public Hospital." Book of Abstracts: Student Research 1 (November 4, 2020): 31. http://dx.doi.org/10.52377/cnuf7812.

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Public health institutions are an integral part of Guyana’s society, within which healthcare workers play a pivotal role. However, research indicates that Guyana’s health facilities are under staffed, which can lead to the risk of on-the-job injury. Moreover, other environmental conditions such as the overcrowding of wards, lack of pharmaceuticals and other institutional deficiencies can lead to stress and result in workplace violence.
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Khubrani, Fatimah Yahyia, and Mona Faisal Al-Qahtani. "Association between Emergency Department Overcrowding and Mortality at a Teaching Hospital in Saudi Arabia." Open Public Health Journal 13, no. 1 (December 31, 2020): 756–62. http://dx.doi.org/10.2174/1874944502013010756.

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Introduction: Emergency Departments (ED) are highly important in hospital settings because they offer 24-hour professional assistance to patients in need of healthcare. However, ED overcrowding has started to become a global healthcare crisis, such that the patient capacity of EDs is no longer sufficient to meet patient demand. Aim: Thus, this study aimed to determine the relationship between ED overcrowding and the mortality rate of patients to draw the attention of decision makers in Saudi Arabia toward this issue, with the hope of ultimately attaining a solution to this problem. Methods: Using patients’ electronic health records that were stored in the Quadra Med system in 2018, we calculated the occupancy rates of the ED of a target teaching hospital at different quarters and associated those figures with the mortality rates for the same quarters. Results: Our results showed that there was no significant association between mortality rate and crowding status in the ED. Nonetheless, we recommend increasing public awareness and bed capacity at EDs in Saudi Arabia because overcrowded EDs can lead to adverse patient outcomes. Conclusion: The present study showed that the highest percentage (38%) of deaths that occurred during the overcrowded period were mostly of patients between 30 and 44 years of age, while patients between 60 and 74 years of age accounted for 36% of deaths. The current study also assessed patient triaging, revealing that the highest number of patients was associated with level four (62.7% of the total patients in the overcrowded ED) and level five (33.1% in the overcrowded ED) triaging. We also discovered higher levels of admission in the critical care unit during the ED overcrowding period compared with other periods.
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Shah, Muslim, Neelam Saleem Punjani, Shaista Rajani Meghani, and Sahreen Malik Bhanji. "Assessing Issues of Overcrowding in Emergency Room of a Tertiary Care Hospital." International Journal of Nursing Education 6, no. 2 (2014): 220. http://dx.doi.org/10.5958/0974-9357.2014.00638.2.

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Saqib, Najmus, and Mahvish Qazi. "Factors associated with overcrowded pediateric emergency rooms in Northern India and possible solutions: a medical school setting." International Journal of Contemporary Pediatrics 6, no. 3 (April 30, 2019): 911. http://dx.doi.org/10.18203/2349-3291.ijcp20191993.

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Background: To quantify the extent of emergency department overcrowding in a tertiary care hospital and to identify possible solutions.Methods: A retrospective hospital record-based study was conducted at Government Medical College Jammu, Jammu and Kashmir, India from the Department of Pediaterics and comprised data of all the patients presenting to the emergency department between 1st January 2018 to 31st December 2018. Demographic characteristics, length of stay (LOS), revisit frequency and consultation status of the patients were determined.Results: Of the 1,17,035 patients, 25,223 (43.89%) were discharged straight away while 24,113 (41.95%) were admitted to different wards and subspecialties. Besides, 6464 (11.25%) patients left the department against medical advice, 861 (1.5%) expired, 741 (1.29%) were referred to other hospitals and 67 (0.12%) were dead on arrival. Of those who were admitted, 1,4498 (60.13%) patients stayed for more than 10 hours before getting the main hospital bed. Mostly, the delays observed were due to delay in getting lab reports, already preoccupied ventilators and incubators in pediatric and neonatal intensive care units, not using checklist for proper reassessment of patients and early discharge, overburdened by patients coming in just for nebulization and intravenous or intramuscular medications, the admitting residents detain the unstable patient longer in emergency department before admission to wards.Conclusions: In conclusion, cooperation of the managers, relevant departments and a multidisciplinary approach are necessary to achieve the goals to reduce overcrowding in the emergency departments.
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Yu, Rong. "Study on Health Management and Service Model of Chifeng Class 3A General Public Hospital." Journal of Clinical and Nursing Research 5, no. 6 (November 30, 2021): 107–12. http://dx.doi.org/10.26689/jcnr.v5i6.2723.

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This study investigates the construction of a health management service mode based on large-scale comprehensive hospitals by analyzing health management service modes at home and abroad, that is, taking the Affiliated Hospital of Chifeng University as an example, establish a health examination hospital, undertake core tasks such as health service operation process, system, monitoring, and system formulation, and take the best medical resources. Attract social medical resources to collaborate and give health service mode of health status monitoring, evaluation, and intervention to health service objects, aided by advanced medical technology. To extend the traditional health management service with the hospital as the protagonist to health management with participation from family and society beyond the hospital, forming a closed-loop, rapid, and efficient health service management system. Thus, through graded quality services, to lessen the difficulties of patients seeing a doctor and to solve the problem of overcrowding and minor ailments in major hospitals.
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Salehi, L., V. Jegatheeswaran, P. Phalpher, R. Valani, and M. Mercuri. "P130: Cumulative daily boarding time: a new way to measure emergency department congestion and hospital-wide flow." CJEM 20, S1 (May 2018): S103. http://dx.doi.org/10.1017/cem.2018.328.

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Introduction: Bed boarding of admitted patients in the Emergency Department (ED) is one of the major contributors to ED overcrowding, and an indicator of hospital-wide deficiencies in capacity and flow. Most indicators of ED overcrowding have measured either counts or percentages of patient subgroups (e.g. number/percentage of patients waiting in triage or number/percentage of admitted patients as compared to full ED census), or specific process time intervals related to patient movement through the hospital (e.g. Physician to Initial Assessment (PIA) time or total ED Length of Stay (EDLOS)). We sought to 1) devise an alternative measure of ED overcrowding that captured the dynamic and disproportionate resource utilization of admitted versus non-admitted patients in the ED, and to 2) determine the association of this measure with selected ED quality metrics for non-admitted patients. Methods: We conducted a retrospective multi-centre observational study at three very high-volume community hospitals in the Greater Toronto Area. Data on all patients visiting the ED during the period between January 1, 2015 and December 31, 2016 were included in the study. We calculated the total daily cumulative boarding time - or time to bed (TTB) - for each day of the study duration. The daily cumulative TTB was calculated as the time from decision to admit to transfer from the ED for all admitted patients within a 24-hour period. We conducted linear regression analysis to determine the association between our measured daily cumulative TTB and daily median and 90th percentile PIA and EDLOS times for non-admitted patients. Results: Preliminary results for 2015 indicate a total cumulative TTB time ranging from 50,973 hours to 191,093 patient-hours for the year, with daily mean cumulative TTB ranging from 140 524 patient-hours/day among the three hospitals. In all three hospitals, there was a statistically significant (p<0.01) positive association between daily cumulative TTB and both median and 90th percentile PIA times for all patients, and median EDLOS times for non-admitted CTAS 1 -3 patients. There was a statistically significant (p<0.05) positive association between daily cumulative TTB and 90th percentile EDLOS for non-admitted CTAS 1-3 patients in two of the three hospitals, with the third hospital showing a positive but non-significant association. Conclusion: Bed boarding constitutes a significant resource cost for EDs, and has a negative impact on timeliness of ED care for the general ED population, particularly more complex (CTAS 1-3) non-admitted patients.
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Ergin, Mehmet, Ahmet Demircan, Ayfer Keles, Fikret Bildik, Evin Aras, Isil Meral, Gul Pamukcu, Betul Ozel, and Mehmet Karamercan. "An Overcrowding Measurement Study in the Adult Emergency Department of Gazi University Hospital, Using the “National Emergency Departments Overcrowding Study” (Nedocs) Scale." Journal of Academic Emergency Medicine 10, no. 2 (June 1, 2011): 60–64. http://dx.doi.org/10.5152/jaem.2011.013.

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Cakir, Oya Durmus, Sebnem Eren Cevik, Mehtap Bulut, Ozlem Guneyses, and Sule Akkose Aydin. "Emergency Department Overcrowding in Turkey: Reasons, Facts and Solutions." Journal of Nepal Medical Association 52, no. 195 (September 30, 2014): 878–85. http://dx.doi.org/10.31729/jnma.2708.

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Introduction: The purpose of this study was to determine the factors affecting the long waiting times of the patients in a university hospital. Methods: This study included 3000 of the adults above 18 years and pediatric trauma patients under 18 years who applied to emergency department between February 2009 and April 2009. The examination period of the physician, length of stay, length of hospitalization, waiting times for hospitalization and follow up times in the emergency department were recorded. Moreover, the patients were divided into four groups according to the reasons for waiting. Results: In our study, the time period between 4 pm-12 pm was determined as the busiest time for the applications. Average length of stay in the emergency department for 3000 patients was 146.7±160.2 minutes. The length of stay for the patients consulted was longer than the length of stay for the ones who were not consulted. Because of the fact that our hospital did not have appropriate bed capacity, 41.1% of the patients waited less than two hours, 13. 4% of the patients waited more than 8 hours. It was also found that the waiting times of the Group two patients (206,7±145,2 minutes) was longer than Group one (95,5±73,9 minutes) patients and the waiting times of Group three patients (470,7±364,7 minutes) was longer than Group one patients. Conclusions: In conclusion, cooperation of the managers, relevant departments and a multidisciplinary approach are necessary to achieve the goals to reduce overcrowding in the emergency departments. Keywords: bed capacity; crowding; emergency department; length of stay.
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Sartini, Marina, Alessio Carbone, Alice Demartini, Luana Giribone, Martino Oliva, Anna Maria Spagnolo, Paolo Cremonesi, Francesco Canale, and Maria Luisa Cristina. "Overcrowding in Emergency Department: Causes, Consequences, and Solutions—A Narrative Review." Healthcare 10, no. 9 (August 25, 2022): 1625. http://dx.doi.org/10.3390/healthcare10091625.

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Overcrowding in Emergency Departments (EDs) is a phenomenon that is now widespread globally and causes a significant negative impact that goes on to affect the entire hospital. This contributes to a number of consequences that can affect both the number of resources available and the quality of care. Overcrowding is due to a number of factors that in most cases lead to an increase in the number of people within the ED, an increase in mortality and morbidity, and a decrease in the ability to provide critical services in a timely manner to patients suffering from medical emergencies. This phenomenon results in the Emergency Department reaching, and in some cases exceeding, its optimal capacity. In this review, the main causes and consequences involving this phenomenon were collected, including the effect caused by the SARS-CoV-2 virus in recent years. Finally, special attention was paid to the main operational strategies that have been developed over the years, strategies that can be applied both at the ED level (microlevel strategies) and at the hospital level (macrolevel strategies).
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CHIA, CHIN LING, and STEPHANIE CHUA. "Hospital Inpatient Tracking System Using RFID Technology." Trends in Undergraduate Research 3, no. 2 (December 29, 2020): c1–15. http://dx.doi.org/10.33736/tur.2729.2020.

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Hospital Inpatient Tracking System using RFID technology is a web application developed for the medical personnel (doctors and nurses) to track the movements of the inpatients in the accident and emergency department of government hospitals. RFID reader fixed in each of the rooms will detect the patient who is wearing the registered tag when enter and leave from the room. It is designed to solve the problems of long queues, overcrowding, delayed treatments, and insufficient beds for patients. Tracking process is taken to track all of the registered patient. At the same time, duration of patient process in each of the room will be recorded and calculated to get the range of processing time in each of the room. It can be used as reference and solving the bottlenecks that faced by hospitals. All the medical personnel need to register and approved by system administrator before accessible to the system.
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Gaeta, Susan, Toni Edwards, Sorayah Bourenane, Carmen E. Gonzalez, Karen McFarland, and Danielle Milling. "Emergency department surge and overcrowding: An interdisciplinary solution for an institutional issue." Journal of Clinical Oncology 37, no. 27_suppl (September 20, 2019): 242. http://dx.doi.org/10.1200/jco.2019.37.27_suppl.242.

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242 Background: Emergency Department (ED) surges at MD Anderson Cancer Center (MDACC) lead to overcrowding, safety risks, privacy concerns, staff burnout, and adverse events associated with delays in care, including death. In 2015, the ED Interdisciplinary Quality & Safety Committee (EDIQSC) at MDACC was developed to review and address safety events. We report on the preliminary results of a quality improvement project with a long-term goal of developing a systematic solution of proactively responding to ED surge and overcrowding (EDSO). Methods: First, EDIQSC reviewed the current literature regarding EDSO. Subsequently an ED Surge and ED Overcrowding Committee (EDSOC) was established to identify solutions to address patient safety risks and improve patient experience in the ED. Results: Literature review showed that NEDOCS (Weiss, SJ et al) was the best scoring tool to calculate ED Overcrowding levels. EDSOC’s weekly meetings facilitated by the Office of Performance Improvement (OPI) explored factors related to EDSO via FMEA a quality improvement tool that proactively evaluate process associated risks. In addition, the following immediate solutions were implemented in the ED: daily status reporting by ED to institutional leaders, a “fast-track” care area implementation, senior executive rounding during ED Surge, electronic medical record (EMR) configuration for high census accommodation, continuous ED Nursing Leadership unit needs assessment, and prioritization of needs based on hospital throughput. Additional interventions in current development include a real-time EMR dashboard accurately reflecting ED capacity, and a NEDOCS guided interdisciplinary operational action plan. Conclusions: ED Surge & Overcrowding is a complex issue with various external and internal contributing factors that cannot be solved with one approach. It is a dynamic, interdisciplinary system that requires vigilant planning, assessment of downstream change effects, stakeholder agility and continuous risk anticipation. EDSOC continues these efforts in an attempt to develop and implement a comprehensive, interdisciplinary tool to direct institutional operations during times of ED Surge & Overcrowding.
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Qazi, Mahvish, Najmus Saqib, and Sachin Gupta. "Overcrowding and possible solutions for a busy gynecological emergency department: a hospital-based setting." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 4 (March 26, 2019): 1451. http://dx.doi.org/10.18203/2320-1770.ijrcog20191198.

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Background: The objective of this study is to determine the trends of patients presenting in Obstetrics and Gynecology emergency department and to identify possible solutions.Methods: This retrospective hospital record-based study was conducted at Government Medical College Jammu, Jammu and Kashmir, India from the department of Gynecology and Obstetrics and comprised data of all patients presenting to the emergency department between 1st January 2018 to 31st December 2018. Patients were assessed in terms of demographic features, presenting complaints, admission types (urgent, non-urgent), referral from other hospitals or coming from home. The total number of patients admitted and the number of patients sent home was also recorded.Results: A total of 1,46,366 patients were analyzed retrospectively. Out of which 63,004 (43.05%) were send home from the OPD while 83,362 (56.95%) presented to the emergency department. Of them, 49,383 (59.24%) were discharged straight away from the ED after emergency treatment and care while 339,79 (40.76%) were admitted. Out of 339,79 patients, 24,932 (73.37%) stayed in the emergency whereas 9047 (26.63%) admitted into different wards for elective procedures. Majority of the patients 26,098 (89.92%) came from home and 2927 patients (10.08%) were referred from other hospitals. Labour pains 7833 (31.42%) was the most common presentation. Trauma was the reason for admission in 112 (0.45%) patients out of 29025. 971 (3.89%) patients presented with gynecological problems. 4093 (14.10%) patients presented with non-urgent indications. Rest of all patients presented with indications which were categorized as urgent and were admitted. All data was analysed using SPSS version 20.Conclusions: To reduce the overcrowding in the emergency department and improve quality of obstetrics and gynecological services, Inpatients and Outpatient departments at primary and secondary care levels need to be strengthened. Patients with non-urgent problems should be provided adequate care at primary and secondary health care centers.
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Peng, Qingjin, Jie Yang, Trevor Strome, Erin Weldon, and Alecs Chochinov. "Bottleneck Detection and Reduction Using Simulation Modeling to Reduce Overcrowding of Hospital Emergency Department." Journal of Modeling and Optimization 12, no. 2 (December 15, 2020): 100–109. http://dx.doi.org/10.32732/jmo.2020.12.2.100.

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Overcrowding is a common problem in hospital emergency departments (EDs) where the ED service cannot meet care demands within reasonable time frames. This paper introduces a quantitative approach using computer simulation modeling for hospital decision makers to explore trade-offs between efficiency, workload and capacity of EDs. A computer simulation model is built based on the ED of a local hospital to improvement efficiency of the ED patient flow. Bottlenecks of the emergency care process are detected using the built model. The ED performance is examined by applying alternative strategies to reduce patient waiting time and length of stay. The proposed method can be applied to improve the operation efficiency of healthcare systems in the current pandemic, COVID -19.
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Stathopoulos, Dimitrios, Eva Ekvall Hansson, and Kjerstin Stigmar. "Exploring the Environment behind In-Patient Falls and Their Relation to Hospital Overcrowdedness—A Register-Based Observational Study." International Journal of Environmental Research and Public Health 18, no. 20 (October 13, 2021): 10742. http://dx.doi.org/10.3390/ijerph182010742.

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(1) Background: Inpatient falls are a serious threat to patients’ safety and their extrinsic factors are, at present, insufficiently described. Additionally, hospital overcrowdedness is known for its malicious effects but its relation to the inpatient falls is currently underexplored. The aim of this study was to explore the distribution of falls and their extrinsic characteristics amongst a range of different clinics, and to explore the correlation and predictive ability of hospital overcrowding in relation to inpatient falls. (2) Methods: An observational, cross-sectional, registry-based study was conducted using retrospective data from an incidence registry of a hospital organization in Sweden during 2018. The registry provided data regarding the extrinsic factors of inpatient falls, including the clinics’ overcrowdedness. Simple descriptive statistics, correlation analysis and simple linear regression analysis were used. (3) Results: Twelve clinics were included. A total of 870 inpatient falls were registered during 2018. Overcrowdedness and total amount of falls were positively and very strongly correlated (r = 0.875, p < 0.001). Overcrowdedness was a significant predictor of the total amount of inpatient falls (p < 0.001, α = 0.05). (4) Conclusions: The characteristics regarding inpatient falls vary among the clinics. Inpatient overcrowding might have a significant role in the prevalence of inpatient falls, but further high-evidence-level studies are required.
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46

Widyani, Fariza Nur Aini, April Poerwanto Basuki, and Djohar Nuswantoro. "Triage Knowledge of Emergency Rooms Nurses at Dr Soetomo Regional General Hospital." Indonesian Journal of Anesthesiology and Reanimation 2, no. 1 (January 30, 2020): 13. http://dx.doi.org/10.20473/ijar.v2i12020.13-19.

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Introduction: Triage is a system to sort patients based on their urgency for care during an emergency. In addition, to determine patient’s severity, triage reduces time wasted and overcrowding in the emergency room.1 Triage errors such as over-triage or under-triage must not exceed 35% and 5% of the total numbers of patients respectively. Dr. Soetomo General Hospital of Surabaya with its status as one of type “A” hospital in Indonesia that has good amenities, facilities, and infrastructures which is also the main referral hospital from Primary or Secondary Health Care, is prone to patients overcrowding. The high number of patients and the demands for high-quality service as the main referral hospital require higher qualification from health care professionals in term of cognitive, skills, and attitude. Objective: This study conducted to evaluate the level of knowledge of the ER (Emergency Room) nurses at Dr. Soetomo General Hospital in 2019 towards triage. Methods and Materials: This study is a quantitative descriptive study using a validated questionnaire with 32 nurses as the samples. Results and Discussion: Demographic profile showed that majority of nurses are: female (52%), age 26 – 35 years old (46 %), graduated from D3 (61%), have been working in this field for >15 years (46%), attended Basic Life Support Training (33%), and have moderate knowledge in triage (61%). Conclusion: Emergency room nurses of Dr Soetomo General Hospital had adequate knowledge in triage. The researcher considers there might be some factors influencing nurse’s knowledge in triage.
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Mtonga, Kambombo, Santhi Kumaran, Chomora Mikeka, Kayalvizhi Jayavel, and Jimmy Nsenga. "Machine Learning-Based Patient Load Prediction and IoT Integrated Intelligent Patient Transfer Systems." Future Internet 11, no. 11 (November 12, 2019): 236. http://dx.doi.org/10.3390/fi11110236.

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A mismatch between staffing ratios and service demand leads to overcrowding of patients in waiting rooms of health centers. Overcrowding consequently leads to excessive patient waiting times, incomplete preventive service delivery and disgruntled medical staff. Worse, due to the limited patient load that a health center can handle, patients may leave the clinic before the medical examination is complete. It is true that as one health center may be struggling with an excessive patient load, another facility in the vicinity may have a low patient turn out. A centralized hospital management system, where hospitals are able to timely exchange patient load information would allow excess patient load from an overcrowded health center to be re-assigned in a timely way to the nearest health centers. In this paper, a machine learning-based patient load prediction model for forecasting future patient loads is proposed. Given current and historical patient load data as inputs, the model outputs future predicted patient loads. Furthermore, we propose re-assigning excess patient loads to nearby facilities that have minimal load as a way to control overcrowding and reduce the number of patients that leave health facilities without receiving medical care as a result of overcrowding. The re-assigning of patients will imply a need for transportation for the patient to move from one facility to another. To avoid putting a further strain on the already fragmented ambulatory services, we assume the existence of a scheduled bus system and propose an Internet of Things (IoT) integrated smart bus system. The developed IoT system can be tagged on buses and can be queried by patients through representation state transfer application program interfaces (APIs) to provide them with the position of the buses through web app or SMS relative to their origin and destination stop. The back end of the proposed system is based on message queue telemetry transport, which is lightweight, data efficient and scalable, unlike the traditionally used hypertext transfer protocol.
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Tsai, Jeffrey Che-Hung, Shao-Jen Weng, Shih-Chia Liu, Yao-Te Tsai, Donald F. Gotcher, Chih-Hao Chen, Chun-An Chou, and Seung-Hwan Kim. "Adjusting Daily Inpatient Bed Allocation to Smooth Emergency Department Occupancy Variation." Healthcare 8, no. 2 (March 28, 2020): 78. http://dx.doi.org/10.3390/healthcare8020078.

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Study Objective: Overcrowding in emergency departments (ED) is an increasingly common problem in Taiwanese hospitals, and strategies to improve efficiency are in demand. We propose a bed resource allocation strategy to overcome the overcrowding problem. Method: We investigated ED occupancy using discrete-event simulation and evaluated the effects of suppressing day-to-day variations in ED occupancy by adjusting the number of empty beds per day. Administrative data recorded at the ED of Taichung Veterans General Hospital (TCVGH) in Taiwan with 1500 beds and an annual ED volume of 66,000 visits were analyzed. Key indices of ED quality in the analysis were the length of stay and the time in waiting for outward transfers to in-patient beds. The model is able to analyze and compare several scenarios for finding a feasible allocation strategy. Results: We compared several scenarios, and the results showed that by reducing the allocated beds for the ED by 20% on weekdays, the variance of daily ED occupancy was reduced by 36.25% (i.e., the percentage of reduction in standard deviation). Conclusions: This new allocation strategy was able to both reduce the average ED occupancy and maintain the ED quality indices.
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Raut, Prashansa Santosh, Reena Wani, Theertha Shetty, Roshni Khade, and Anjali Mulchandani. "Prevalence of surgical site infection post caesarean with increased patient load during COVID-19 pandemic in tertiary care centre." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 8 (July 26, 2021): 3053. http://dx.doi.org/10.18203/2320-1770.ijrcog20212953.

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Background: Increased referrals and workload during the pandemic lead to overcrowding in hospitals and increase in LSCS rates. Surgical site infection is one of the most common complication post LSCS causing physical and mental duress to the patients. The objective of the study was to analyse the effect of COVID-19 on SSI, the incidence, commonly associated factors and bacteriology of SSI. The design was prospective study design.Methods: 577 patients undergoing LSCS were studied from Day 1 till 30 days post LSCS from 1st August 2020 to 31st October 2020.Results: Out of 577, 28 (4.85%) patients developed SSI. 60% of SSI in our study were unbooked, 50% had haemoglobin less than 9.9 g/dl. Most common risk factor for developing of SSI included pre-eclampsia (32.14%) followed by previous LSCS (28.57%). Common organism isolate was MRSA (25%) and 75% required surgical management.Conclusions: Regular ANC visits can help in managing comorbidities at an earlier stage leading to reduction in SSI. Strict aseptic precautions should be followed to reduce SSI in cases with PROM and second stage arrest. SSI rate is not influenced by COVID-19 status but hospital facilities and overcrowding definitely have an effect.
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Taif, Fatima. "Reduction of Boarding Times to the Emergency Department." INTERNATIONAL JOURNAL OF MANAGEMENT & INFORMATION TECHNOLOGY 10, no. 5 (December 31, 2014): 2131–35. http://dx.doi.org/10.24297/ijmit.v10i5.615.

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Emergency hospital services (ED) was the main hospital entrance door and so was the almost obligatory passage for patients before admission in most health units. The practice of blocking admitted patients (patients IP) on stretchers in the corridors of the hospital emergency services for hours or days, called "boarding" causes emergency space and can be harmful to patients. Boarding increases patient morbidity, length of hospital stay, and mortality. In this article, we make the modeling of boarding patients in the emergency department to minimize overcrowding in emergency departments, using a network of queues open to the MMC. The results of this paper help the hospital administration to test alternative policies to improve overall performance.
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