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How to Solve Emergency Department Overcrowding

By Anton Helman, MD, CCFP(EM), FCFP | on November 19, 2019 | 2 Comments
EM Cases
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Explore This Issue
ACEP Now: Vol 38 – No 11 – November 2019

Pages: 1 2 3 4 | Single Page

Topics: Boarding TimeCrowdingInpatient BedsOutpatientOvercrowdingPractice Management

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About the Author

Anton Helman, MD, CCFP(EM), FCFP

Dr. Helman is an emergency physician at North York General Hospital in Toronto. He is an assistant professor at the University of Toronto, Division of Emergency Medicine, and the education innovation lead at the Schwartz/Reisman Emergency Medicine Institute. He is the founder and host of Emergency Medicine Cases podcast and website (www.emergencymedicinecases.com).

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2 Responses to “How to Solve Emergency Department Overcrowding”

  1. December 3, 2019

    Benjamin Brenner Reply

    Thank you for work on this, Anton. I work in a busy department outside of Los Angeles where this is an important issue as well.

    I’m curious if, during your research, you uncovered anything regarding physician’s/other provider’s justification for ordering additional tests beyond what is mentioned in the article. If we are going to talk about the burden additional diagnostic testing puts on a department, we should also investigate how often tests are ordered to “protect” oneself, ie defensive medicine, which seems more and more prevalent given the litigious climate in medicine today.

    • December 17, 2019

      Anton Helman, MD, CCFP, CAC(EM), FCFP Reply

      I agree that test ordering is sometimes done for medico-legal concerns rather than for patient safety, likely more-so in the U.S. than in Canada where I work. While I haven’t come across any particular literature on the topic I think it’s up to educators to continue to emphasize what is best for the patient rather than best for medico-legal purposes. There certainly is an association between increased test ordering and overcrowding/access block with no improvement in patient safety.

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