R Rehmani1. 1. Section of Emergency Medicine, The Aga Khan University Hospital, Karachi.
Abstract
OBJECTIVE: To quantify the extent of Emergency Section overcrowding at a tertiary care hospital and to identify possible solutions. METHODS: This was a retrospective chart review of all the patients presented to the Aga Khan University Hospital's (AKUH) Emergency Section (ES). The ES information system has an automatic patient log and generates daily report for patients who stay longer than 6 hours. The charts of all patients who stayed longer than 6 hours were reviewed. RESULTS: Among 9630 patients, 1999 (20.8%) were held in the ES for more than 6 hours. Of those 134 (6.7%) were discharged from the ES, while 1535 (76.8) were admitted to the hospital. About two-third of all delays were due to unavailability of bed, followed by financial constraints, involvement of multiple specialty, and because the admitting residents wanted to investigate the patients more thoroughly. CONCLUSION: Significant overcrowding exists in Emergency Section of the hospital. Four solutions were proposed: (1) early discharges of in-patients, (2) creation of a holding unit, (3) flexible ward assignment, (4) active inter-facility transfer. These efforts will lead to an optimal care in the Emergency Section in rising patient demand.
OBJECTIVE: To quantify the extent of Emergency Section overcrowding at a tertiary care hospital and to identify possible solutions. METHODS: This was a retrospective chart review of all the patients presented to the Aga Khan University Hospital's (AKUH) Emergency Section (ES). The ES information system has an automatic patient log and generates daily report for patients who stay longer than 6 hours. The charts of all patients who stayed longer than 6 hours were reviewed. RESULTS: Among 9630 patients, 1999 (20.8%) were held in the ES for more than 6 hours. Of those 134 (6.7%) were discharged from the ES, while 1535 (76.8) were admitted to the hospital. About two-third of all delays were due to unavailability of bed, followed by financial constraints, involvement of multiple specialty, and because the admitting residents wanted to investigate the patients more thoroughly. CONCLUSION: Significant overcrowding exists in Emergency Section of the hospital. Four solutions were proposed: (1) early discharges of in-patients, (2) creation of a holding unit, (3) flexible ward assignment, (4) active inter-facility transfer. These efforts will lead to an optimal care in the Emergency Section in rising patient demand.
Authors: Nathan R Hoot; Stephen K Epstein; Todd L Allen; Spencer S Jones; Kevin M Baumlin; Neal Chawla; Anna T Lee; Jesse M Pines; Amandeep K Klair; Bradley D Gordon; Thomas J Flottemesch; Larry J LeBlanc; Ian Jones; Scott R Levin; Chuan Zhou; Cynthia S Gadd; Dominik Aronsky Journal: Ann Emerg Med Date: 2009-08-29 Impact factor: 5.721
Authors: Sama Mukhtar; Syed Ghazanfar Saleem; Saima Ali; Sarfraz Ahmed Khatri; Anna Q Yaffee Journal: Pak J Med Sci Date: 2021 May-Jun Impact factor: 1.088
Authors: Ziad Obermeyer; Samer Abujaber; Maggie Makar; Samantha Stoll; Stephanie R Kayden; Lee A Wallis; Teri A Reynolds Journal: Bull World Health Organ Date: 2015-05-26 Impact factor: 9.408
Authors: Nakul P Raykar; Rachel R Yorlets; Charles Liu; Roberta Goldman; Sarah L M Greenberg; Meera Kotagal; Paul E Farmer; John G Meara; Nobhojit Roy; Rowan D Gillies Journal: BMJ Glob Health Date: 2016-12-16
Authors: Katherine Albutt; Rachel R Yorlets; Maria Punchak; Peter Kayima; Didacus B Namanya; Geoffrey A Anderson; Mark G Shrime Journal: PLoS One Date: 2018-04-17 Impact factor: 3.240
Authors: Jawad Karamat; Tong Shurong; Naveed Ahmad; Sana Afridi; Shahbaz Khan; Kashif Mahmood Journal: Int J Environ Res Public Health Date: 2019-02-12 Impact factor: 3.390
Authors: Samita Giri; Tormod Rogne; Oddvar Uleberg; Eva Skovlund; Sanu Krishna Shrestha; Rajendra Koju; Jan Kristian Damås; Erik Solligård; Kari R Risnes Journal: J Glob Health Date: 2019-12 Impact factor: 4.413
Authors: Muhammad Muslim Noorani; Muhammad Farhan Khaliq; Maria Shoaib; Asfandyar Sheikh; Um-E-Roman Moughal; Wardah Moazzum; Syed Arsalan Ali Journal: Int Arch Med Date: 2014-09-24