Hostname: page-component-8448b6f56d-c4f8m Total loading time: 0 Render date: 2024-04-18T09:51:10.490Z Has data issue: false hasContentIssue false

Sorry—we’re full! Access block and accountability failure in the health care system

Published online by Cambridge University Press:  01 April 2015

Grant Innes*
Affiliation:
Department of Emergency Medicine, University of Calgary, Calgary, AB
*
Correspondence to: Dr. Grant Innes, Department of Emergency Medicine, University of Calgary, 416 12 Street NW, Calgary, AB T2N 1Y8; grant. innes@albertahealthservices.ca

Abstract

Image of the first page of this content. For PDF version, please use the ‘Save PDF’ preceeding this image.'
Type
Administration Series
Copyright
Copyright © Canadian Association of Emergency Physicians 2015 

References

1. Institute of Medicine Committee on the Future of Emergency Care in the United States Health System. Hospital-based emergency care: at the breaking point. Washington (DC) National Academies Press; 2006, Executive summary available at: http://www.nap.edu/catalog/11621.html (accessed August 10, 2012).Google Scholar
2. Canadian Association of Emergency Physicians Access to acute care in the setting of emergency department overcrowding. CJEM 2003;5:8186.Google Scholar
3. Fatovich, DM, Nagree, Y, Sprivulis, P. Access block causes emergency department overcrowding and ambulance diversion in Perth, Western Australia. Emerg Med J 2005;22:351354, doi:10.1136/emj.2004.018002.CrossRefGoogle ScholarPubMed
4. American College of Emergency Physicians Task Force on Boarding. Emergency department crowding: high-impact solutions. Available at: http://www.acep.org/clinical---practicemanagement/2008-emergency-department-crowding-report--high-impact-solutions (accessed October 25, 2013).Google Scholar
5. Rowe, BH, Bond, K, Ospina, MB, et al Emergency department overcrowding in Canada: what are the issues and what can be done? Technology overview No 21 Ottawa Canadian Agency for Drugs and Technologies in Health; 2006.Google Scholar
6. Hoot, NR, Aronsky, D. Systematic review of emergency department crowding: causes, effects, and solutions. Ann Emerg Med 2008;52:126136, doi:10.1016/j.annemergmed. 2008.03.014.CrossRefGoogle ScholarPubMed
7. Kellermann, AL. Crisis in the emergency department. N Engl J Med 2006;355:13001303, doi:10.1056/NEJMp068194.Google Scholar
8. Canadian Association of Emergency Physicians. Position statement on overcrowding 2009. Available at: http://caep.ca/resources/position-statements-and-guidelines (accessed October 25, 2013).Google Scholar
9. Pitts, SR, Pines, JM, Handrigan, MT, Kellermann, AL. National trends in emergency department occupancy, 2001 to 2008: effect of inpatient admissions versus emergency department practice intensity. Ann Emerg Med 2012;60:679686, doi:10.1016/j.annemergmed.2012.05.014.Google Scholar
10. Moskop, JC, Sklar, DP, Geiderman, JM, et al. Emergency department crowding—barriers to reform and strategies to overcome them. Ann Emerg Med 2009;53:612617, doi:10.1016/j.annemergmed.2008.09.024.Google Scholar
11. Bell, R, Willett, J, Oliver, J.. An Expert Working Group reporting to the Physician Hospital Care Committee, a tripartite committee of the Ontario Hospital Association, the Ontario Medical Association and the Ontario Ministry of Health and Long-Term Care 2006, Improving access to emergency care: addressing system issues.Google Scholar
12. Canadian Institute for Health Information. Access to inpatient beds and patient flow. Available at: https://secure.cihi.ca/estore/productSeries.htm?locale5en&pc5PCC289 (accessed October 26, 2013).Google Scholar
13. Chalfin, DB, Trzeciak, S, Likourezos, A, et al. Impact of delayed transfer of critically ill patients from the emergency department to the intensive care unit. Crit Care Med 2007;35:14771483, doi:10.1097/01.CCM.0000266585.74905.5A.Google Scholar
14. Liew, D, Liew, D, Kennedy, MP. Emergency department length of stay independently predicts excess inpatient length of stay. Med J Aust 2003;179:524526.Google Scholar
15. Richardson, DB. The access-block effect: relationship between delay to reaching an inpatient bed and inpatient length of stay. Med J Aust 2002;177:492495.Google Scholar
16. Krochmal, P, Riley, TA. Increased health care costs associated with ED overcrowding. Am J Emerg Med 1994;12:265266, doi:10.1016/0735-6757(94)90135-X.CrossRefGoogle ScholarPubMed
17. Hwang, P, Richardson, LD, Sonuyi, TO, et al. The effect of emergency department crowding on the management of pain in older adults with hip fracture. J Am Geriatr Soc 2006;54:270275, doi:10.1111/j.1532-5415.2005.00587.x.Google Scholar
18. Pines, JM, Hollander, JE. Emergency department crowding is associated with poor care for patients with severe pain. Ann Emerg Med 2008;51:15, doi:10.1016/j.annemergmed.2007.07.008.Google Scholar
19. Geelhoed, GC, de Klerk, NH. Emergency department overcrowding, mortality and the 4-hour rule in Western Australia. Med J Aust 2012;196:122126, doi:10.5694/mja 11.11159.Google Scholar
20. Sprivulis, PC, DaSilva, JA, Jacobs, IG, et al. The association between overcrowding and mortality among patients admitted via Western Australian emergency departments. Med J Aust 2006;184:208212.Google Scholar
21. Richardson, DB. Increase in patient mortality at 10 days associated with emergency department overcrowding. Med J Aust 2006;184:213216.Google Scholar
22. Guttmann, A, Schull, MJ, Vermeulen, MJ, Stukel, TA. Association between waiting times and short-term mortality and hospital admission after departure from emergency department: population based cohort study from Ontario, Canada. BMJ 2011;342:d2983 doi:10.1136/bmj.d2983.CrossRefGoogle ScholarPubMed
23. McCarthy, ML, Zeger, SL, Ding, R, et al. Crowding delays treatment and lengthens emergency department length of stay, even among high-acuity patients. Ann Emerg Med 2009;54:492503, doi:10.1016/j.annemergmed.2009.03.006.Google Scholar
24. Schull, MJ, Vermeulen, M, Slaughter, G, et al. Emergency department crowding and thrombolysis delays in acute myocardial infarction. Ann Emerg Med 2004;44:577585, doi:10.1016/j.annemergmed.2004.05.004.Google Scholar
25. Scheuermeyer, FX, Christenson, J, Innes, G, et al. Safety of assessment of patients with potential ischemic chest pain in an emergency department waiting room: a prospective comparative cohort study. Ann Emerg Med 2010;56:455462, doi:10.1016/j.annemergmed.2010.03.043.Google Scholar
26. Kulstad, B, Kelley, KM. Overcrowding is associated with delays in percutaneous coronary intervention for acute myocardial infarction. Int J Emerg Med 2009;2:149154, doi:10.1007/s12245-009-0107-x.Google Scholar
27. Fee, C, Weber, EJ, Maak, CA, et al. Effect of emergency department crowding on time to antibiotics in patients admitted with community-acquired pneumonia. Ann Emerg Med 2007;50:501509, doi:10.1016/j.annemergmed.2007.08.003.Google Scholar
28. Eckstein, M, Chan, LS. The effect of emergency department crowding on paramedic ambulance availability. Ann Emerg Med 2004;43:100105, doi:10.1016/S0196-0644(03)00747-9.Google Scholar
29. Fatovich, DM, Hirsch, RL. Entry overload, emergency department overcrowding, and ambulance bypass. Emerg Med J 2003;20:406409, doi:10.1136/emj.20.5.406.Google Scholar
30. Barbera, JA, Macintyre, AG, DeAtley, CA. Ambulances to nowhere: America’s critical shortfall in medical preparedness for catastrophic terrorism BCSIA Discussion Paper 2001-15, ESDP Discussion Paper ESDP-2001-07 Boston John F. Kennedy School of Government, Harvard University October 2001.Google Scholar
31. Institute of Medicine. Future of Emergency Care. Hospitalbased emergency care: at the breaking point. Washington (DC) The National Academies Press; 2006.Google Scholar
32. Health Quality Council of Alberta. Review of the quality of care and safety of patients requiring access to emergency department care and cancer surgery 2012.Google Scholar
33. Government Accountability Office. GAO report: crowding continues to occur, and patients wait longer than recommended time frames. April 2009. Available at: http://www.gao.gov/assets/290/289054.html (accessed October 25, 2013).Google Scholar
34. Yong, PL, Saunders, RS, Olsen, LA. editors Institute of Medicine The healthcare imperative: lowering costs and improving outcomes: workshop series summary. Washington (DC) The National Academies Press; 2010.Google Scholar
35. Schuur, JD, Venkatesh, AK. The growing role of emergency departments in hospital admissions. N Engl J Med 2012;367:391393, doi:10.1056/NEJMp1204431.Google Scholar
36. Morganti, KG, Bauhoff, S, Blanchard, JC. The evolving role of emergency departments in the United States. Santa Monica (CA) RAND Corporation; 2013.Google Scholar
37. Tang, N, Stein, J, Hsia, RY, et al. Trends and characteristics of US emergency department visits, 1997-2007. JAMA 2010;304:664670, doi:10.1001/jama.2010.1112.CrossRefGoogle ScholarPubMed
38. Gindi, RM, Cohen, RA, Kirzinger, WK. Emergency room use among adults aged 18–64: early release of estimates from the National Health Interview Survey, January–June 2011. National Center for Health Statistics; May 2012. Available at: http://www.cdc.gov/nchs/nhis/releases.htm.Google Scholar
39. Doyal, L. Needs, rights and equity: moral quality in healthcare rationing. Qual Healthc 1995;4:273283, doi:10.1136/qshc.4.4.273.Google Scholar
40. Emanuel, EJ, Emanuel, LL. What is accountability in health care? Ann Intern Med 1996;124:229239, doi:10.7326/0003-4819-124-2-199601150-00007.Google Scholar
41. Robertson, J, Walkom, EJ, Henry, DA. Health systems and sustainability: doctors and consumers differ on threats and solutions. PloS One 2011;6(4):e19222 doi:10.1371/journal.-pone.0019222.CrossRefGoogle ScholarPubMed
42. Brett, AS, McCullough, LB. Addressing requests by patients for nonbeneficial interventions. JAMA 2012;307:149151, doi:10.1001/jama.2011.1999.Google Scholar
43. Brody, H.. From ethics of rationing to ethics of waste avoidance. N Engl J Med 2012;366:19491951, doi:10.1056/NEJMp1203365.Google Scholar
44. Smith, R, Hiatt, H, Berwick, D. Shared ethical principles for everybody in health care: a working draft from the Tavistock group. BMJ 1999;318:248251, doi:10.1136/bmj.318.7178.248.Google Scholar
45. Shortell, SM, Waters, TM, Clarke, KWB, et al. Physicians as double agents: maintaining trust in an era of multiple accountabilities. JAMA 1998;280:11021108, doi:10.1001/jama.280.12.1102.Google Scholar
46. Davies, HTO, Nutley, SM, Mannion, R. Organizational culture and quality of health care. Qual Health Care 2000;9:111119, doi:10.1136/qhc.9.2.111.Google Scholar
47. Girod, J, Beckman, AW. Just allocation and team loyalty: a new virtue ethic for emergency medicine. J Med Ethics 2005;31:567570, doi:10.1136/jme.2004.009332.Google Scholar
48. Emanuel, EJ, Fuchs, VR. The perfect storm of overutilization. JAMA 2008;299:27892793, doi:10.1001/jama.299.23.2789.Google Scholar
49. Cassel, CK, Guest, J. Choosing wisely: helping physicians and patients make smart decisions about their care. N Engl J Med 2012;307:18011803.Google Scholar
50. Berwick, DM, Hackbarth, AD. Eliminating waste in US health care. JAMA 2012;307:15131516, doi:10.1001/jama.2012.362.Google Scholar
51. Weinstein, MC, Skinner, JA. Comparative effectiveness and health care spending—implications for reform. N Engl J Med 2010;362:460465, doi:10.1056/NEJMsb0911104.Google Scholar
52. Fisher, ES, Wennberg, DE, Stukel, TA, et al. The implications of regional variations in Medicare spending, 2: Health outcomes and satisfaction with care. Ann Intern Med 2003;138:288298, doi:10.7326/0003-4819-138-4-200302180-00007.Google Scholar
53. Welch, WG, Schwartz, L, Woloshin, S. Overdiagnosed: making people sick in the pursuit of health. Boston Beacon Press; 2011.Google Scholar
54. Grady, D, Redberg, RF. Less is more: how less health care can result in better health. Arch Intern Med 2010;170:749750, doi:10.1001/archinternmed.2010.90.Google Scholar
55. Berney, L, Kelly, M, Doyal, L, et al. Ethical principles and the rationing of health care: a qualitative study in general practice. Br J Gen Pract 2005;55:620625.Google Scholar
56. Kelen, G, Kraus, CK, McCarthy, ML, et al.. Inpatient disposition classification for the creation of hospital surge capacity: a multi-phase study. Lancet 2006;368:19841990, doi:10.1016/S0140-6736(06)69808-5.Google Scholar
57. Kelen, G, McCarthy, ML, Kraus, CK, et al. Creation of surge capacity by early discharge of hospitalized patients at low risk for untoward events. Disaster Med Public Health Prep 2009;3(Suppl 1):S17.Google Scholar
58. Darby, M. Health care quality: from data to accountability. Acad Med 1998;73:843853, doi:10.1097/00001888-199808000-00009.Google Scholar
59. Harber, B, Ball, E. Redefining accountability in health care. Managing Change 2003, (Spring) 1322.Google Scholar