OVERCROWDING PATIENT AND IMPROVING EMERGENCY PATIENT FLOW IN EMERGENCY DEPARTMENT: A LITERATURE REVIEW
ABSTRACT: Overcrowding
discussion in emergency department (ED) has become a great issue over decade.
The EDs plays a significant role as a frontline in hospital which performing
good or bad quality of care. Identifying bottleneck relative to patient flow in
the ED is one of important factor to determine the quality of care. The EDs can
be considered as the heart of the hospital where increasing number of patient
in the ED link to the increasing number of patients in the hospital. Therefore
performing delivery of care in the ED particularly when its deal with
overcrowding could represent the quality of care in hospital as a whole.The
study aimed to explore factors related to overcrowding patient and improving emergency
patient flow in emergency department. The study was about a literature review
and the articlesused in the literature review were full text. The literature
review methods were collected and analyzed articles about overcrowding
emergency department, emergency department patient flow, the quality of service
in emergency room and emergency department performance towards waiting time and
length of visit. Articles collected through electronic database, science direct
with keywords overcrowding the ED, the ED patient flow, emergency quality
services. There were three factors that affect overcrowding patient: prolonged
waiting time, triaging, and shortage of doctors and nurses ratio in the ED
room. When those three factors are combined, the overcrowding patient in the ED
could be handled and it may probably result to improving patient flow. The
prolonged waiting time have created delayed of care, patient leaving without
being seen/treatment and dissatisfaction among patients The same idea was
presented that triaging somehow invent prolonged time especially for those
patients in semi-urgent or non-urgent that need treatment between 61 minutes to
2 hours. Those patients are dominantly in the ED and if the patients do not
understand triage system they become short-tempered and complaining. The last
one was the number of emergency physician and nurses are being backbone of
services, however, if it is still lack of number thus leading to troublesome
which may significantly affect to effectiveness of care and patient safety. The
findings from the above-cited studies suggested that assign fast track for
semi-urgent and non-urgent patient should be treated and discharged promptly
and properly. Also, expanding the number of physician and nurse staffs with the
ratio 1 and 2 respectively as well as developing standardized job descriptions
is mandatory. Moreover, extent inpatient bed capacity specifically to critical
care unit and increase number of available room for emergency room admission.
Penulis: Dewi Kartikawati
Ningsih
Kode Jurnal: jpkeperawatandd150374
