Published date: Dec 05 2018

Journal Title: KnE Life Sciences

Issue title: The 2nd International Conference on Hospital Administration (The 2nd ICHA)

Pages: 50–59

DOI: 10.18502/kls.v4i9.3557

L Tampubolon

Pujiyanto .puji_fkm@ui.ac.id

ED crowding has become an emerging threat to patient safety and health systems worldwide. As the problem of ED crowding continues to evolve, it is important to see factors that influence the overcrowding at the emergency department. Hospital beds are a scarce resource and always in need. When the accident and emergency department admits a patient, there may not be an available bed that matches the requested speciality. Hence, the lack of available hospital beds has become a major difficulty, and changing bed-management policy could improve the patient flow. A systematic review conducted the PRISMA flowchart using online databases such as ProQuest and Google scholar with bed management, emergency department,
overcrowding as keywords, restricting academic journals and articles published between 2003 and 2016. There are some factors associated with ED crowding. Identifying, developing and implementing strategies to improve the hold time required and other barriers would be important to improve patient flow. Changing policies for hospital bed management is worth exploring to improve hospital patient flow and LOS (Length of stay). With this insight, the hospital administration can be better equipped to devise strategies to reduce bed overflow and therefore improved patient care.

Keywords: bed management, emergency department, overcrowding

[1] Claret, P. G., et al. (2015). Consequences for overcrowding in the emergency room of a change in bed management policy on available in-hospital beds. Journal of the Australian Healthcare & Hospitals Association, vol. 40, no. 4, p. 466.


[2] Richardson, D. B. and Mountain, D. (2009). Myths versus facts in emergency department overcrowding and hospital access block. The Medical Journal of Australia, vol. 190, no. 7, pp. 369–374.


[3] American College of Emergency Physicians. (2006). Public training in cardiopulmonary resuscitation and public access defibrillation PlumX Metrics. Annals of Emergency Medicine.


[4] Bernstein, S. L., et al. (2009). The effect of emergency department crowding on clinically oriented outcomes. Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine, vol. 16, no. 1, pp. 1–10.


[5] College of Emergency Medicine. (2014). Crowding in Emergency Departments. The College of Emergency Medicine.


[6] Geelhoed, G. C. and de Klerk, N. H. (2012). Emergency department overcrowding, mortality and the 4-hour rule in Western Australia. The Medical Journal of Australia, vol. 196, no. 2, pp. 122–126.


[7] Teow, K. L., El-Darzi, E., Foo, C., et al. (2012). Intelligent analysis of acute bed overflow in a tertiary hospital in Singapore. Journal of Medical Systems, vol. 36, no. 3, pp. 1873–1882.


[8] Baru, R. A., Cudney, E. A., Guardiola, I. G., et al. (2015). Systematic review of operations research and simulation methods for bed management, in Proceedings of the IIE Annual Conference and Expo, pp. 298–306. Nashville, TN.


[9] Morri, Z. S., Boyle, A., Beniuk, K., et al. (2012). Emergency department crowding: Towards an agenda for evidence-based intervention. Emergency Medicine Journal, vol. 29, no. 6, pp. 460–466.


[10] Johnson, K. D. and Winkelman, C. (2011). The effect of emergency department crowding on patient outcomes: A literature review. Advanced Emergency Nursing Journal, vol. 33, no. 1, pp. 39–54.


[11] Barrett, L., Ford, S., and Ward-Smith, P. (2012). A bed management strategy for overcrowding in the emergency department. Nursing Economic$, vol. 30, no. 2, pp. 82–86.


[12] Bellow, A. A., Jr. and Gillespie, G. L. (2013). The evolution of ED Crowding. Journal of Emergency Nursing, vol. 40, no. 2, pp. 153–161.