National Health Care Provider Associations Join Forces to Reduce Emergency Department Crowding

Des Plaines, Illinois, July 13, 2011—Emergency department crowding has long been a serious problem for hospitals, health care providers and patients.  It plays a significant factor in poor patient outcomes and contributes to violence against emergency department personnel.  Across the country, many hospitals and health care systems are working to reduce crowding, but this can be difficult without accurate and standardized metrics. While many organizations and associations have established emergency department metrics, there are no agreed-upon standard definitions for them.

Now, a group of nine leading associations for emergency department health providers and staff have signed a consensus statement that for the first time proposes standardized emergency department metrics, with an eye toward creating benchmarks that will inform strategies to reduce emergency department crowding and boarding.  The Emergency Nurses Association (ENA) spearheaded the effort, reaching out to stakeholder organizations and convening the first meeting on developing standardized metrics February 2009.

“Emergency department crowding is a serious health care problem that is only getting worse,” said AnnMarie Papa, DNP, RN, CEN, NE-BC, FAEN, President of the Emergency Nurses Association. “Addressing it is one of ENA’s top clinical priorities, but we can’t solve a problem if we can’t agree on how to quantify it. This consensus statement is a first and important step in reducing crowding and boarding in emergency rooms and helping us provide better and faster care to our patients.”

The organizations that signed onto the final statement are: the American Academy of Emergency Medicine; American Academy of Pediatrics; American Association of Critical-Care Nurses; American College of Emergency Physicians; American Nurses Association; Association of periOperative Registered Nurses; Emergency Department Practice Management Association; Emergency Nurses Association; and National Association of EMS Physicians.

The statement includes the six agreed-upon definitions:

·         what an emergency department is;

·         emergency department arrival time;

·         emergency department offload time;

·         emergency department transfer of care from prehospital providers time;

·         emergency department triage time; and

·         emergency department treatment space time.

With the ever increasing pressures on emergency departments around the country, it is imperative that accurate and consistent data be collected to monitor the flow of patients into the health care delivery system.

“Most high acuity and critical care patients continue to enter the health care system through the emergency department. Universally defined time stamps and intervals will ensure accurate patient hand-offs and consistency in health records,” says Robi Hellman, Clinical Practice Manager, American Association of Critical-Care Nurses.

But any solutions to the issues facing emergency departments will require the cooperation of multiple disciplines within the emergency care profession.

“By working together, the EMS, nursing and physician communities have achieved an important consensus on these metrics.  Now we can begin the process of quantifying the issues we face in emergency medicine so that we can find the solutions we all know are needed,” added Papa.

To access the consensus statement online, go to www.ena.org.