Implementation of solutions to emergency department crowding needed

An editorial published online on Friday in Annals of Emergency Medicine says the fact that a serious study showing that acute coronary patients can be treated in the waiting room of a severely crowded emergency department shows how bad things have gotten ("Waiting Room Medicine: Has It Really Come to This?").  http://bit.ly/9VxyYb

"Allowing hospital administrators to keep ignoring ED crowding doesn't help our patients, it enables their abuse," said the editorial's author, Arthur Kellermann, MD, MPH, FACEP, of the Rand Corporation in Washington, DC.  "The constant improvising that emergency physicians do in order to cope with crowding in their ERs may be technically feasible, but it is wrong.  While I admire the fact that emergency physicians will go to any length to protect their patients, what is it accomplishing?  Patients deserve better, and so do our communities."  

The editorial cites three reasons emergency department crowding is allowed to persist:  economics, ignorance and acculturation.  

"Like the proverbial frog in a pot, we have grown acclimatized to conditions that were once unacceptable," said Dr. Kellermann.  "Those of us who treat battered women sometimes wonder, 'why does she put up with it?' We should ask ourselves the same question."

Dr. Kellermann noted that solutions to emergency department crowding exist and should be implemented nationwide.

"This is not only vital for patient safety, but for disaster preparedness," he said.  "Emergency department crowding makes a mockery of the concept of 'surge capacity.'"