Call for pediatricians to educate the public about emergency department overcrowding

Each year more than 100 million Americans, including 30 million children, receive emergency care - a 600 percent increase since 1958. The result is overtaxed emergency departments (EDs) and potentially substandard care for children and families.

A new policy from the American Academy of Pediatrics (AAP) calls on pediatricians to educate the public about ED overcrowding and to work on specific solutions with families, health professionals, legislators and policymakers.

The policy, "Overcrowding Crisis in our Nation's Emergency Departments: Is Our Safety Net Unraveling?" examines the state of America's EDs and the causes and effects of overcrowding. Overcrowding puts both patients and health care professionals at risk.

The new policy dispels a common misconception that emergency room overcrowding is solely due to patients coming in with minor illnesses. Much overcrowding has to do with a smaller supply of hospital beds in recent years, causing patients who should be admitted for inpatient care to be stalled in emergency rooms.

The policy statement also gives recommendations for how pediatricians can help reform the system. These include:

• Discussing with families the management of severe illness or injury and the use of emergency services before the emergency occurs. People make better-informed decisions if they are prepared.

• Coordinating effective follow-up care for ED visits.

• Advocating for improved Medicaid reimbursement for pediatricians.

• Supporting medical liability reform.

• Connecting patients to a fully functional medical home. When children and adults have a medical home, they have medical care that is accessible, continuous, comprehensive and coordinated, and fewer visits to the ED become necessary.

The policy stresses that "pediatricians must serve as powerful advocates for improved health care for all children. The problem of ED overcrowding cannot be solved without reforms in our current health care systems that will provide an accessible and comprehensive medical home."