3 Common Emergency Department Problems—and Ideas for Solving Them

The emergency room is an eventful place, but some departmental challenges can make it more hectic. From crowding to delays, these problems can significantly strain the ER.

Below, explore three top emergency department problems, their consequences—and possible solutions.

CHALLENGE 1

Overcrowding

Overcrowding is a significant problem in emergency departments across the nation. It occurs when more patients are in the hospital—including the ER—than there are staff and resources available to help them.

Often, this is when ERs move to “boarding” patients or have them on gurneys in the hallway until hospital beds become available. Unfortunately, this is a common issue among emergency departments, with up to 90% reporting that it happens regularly.

Possible causes of overcrowding include:

• Decreased capacity
• Hospital closures
• Large amounts of uninsured people or those on Medicaid
• Unnecessary ER visits (i.e., those that could have been addressed in another setting, like primary or urgent care)

On top of that, boarding leads to issues with patient services, including:

• Worse outcomes, sometimes including death
• Delayed access to appropriate care, including pain control and antibiotics
• Higher risk of medical errors

Since ERs should prioritize fast, high-quality care, overcrowding can make it hard to deliver.

CHALLENGE 2

Staffing Shortages

Staffing shortages have become another major emergency department challenge at many hospitals. They spiked during the COVID-19 pandemic and continue today. Many factors have contributed to a lack of staff, including burnout and trauma.

In fact, a report from the American Hospital Association estimates a shortage of up to 3.2 million healthcare workers by 2026. Unfortunately, the less staff available to respond in the ER can result in many issues, such as:

• Higher risk of medical error
• Increased wait times
• Longer ER and hospital stays
• More people who leave without being seen
• Greater chance of comorbidities, such as cardiac arrest
• Delayed time for medication administration or therapeutic interventions

Since emergency department staffing shortages will likely persist, innovative solutions are necessary to reduce the strain.

CHALLENGE 3

Ancillary Service Delays

Emergency rooms depend on other departments for ancillary services, such as labs and imaging. For example, if a patient arrives with the symptoms of a GI bleed, but there is a delay in blood tests or CT scans, they must wait longer for treatment.

Other issues associated with service delays include:

• Overcrowding
• Department dysfunction
• Patient dissatisfaction
• Increased length of ER and hospital stays

Most of these emergency room issues influence one another, making it imperative to make changes to improve the ER’s function.

Possible Solutions for Emergency Department Issues

How do you solve these three major problems found in many ERs? There’s no one-size-fits-all or straightforward answer. The most crucial part of solving these issues is improving patient care—so that’s the focus of most possible solutions.

Strategies the American College of Emergency Physicians suggests to ease these challenges include:

• Use flexible scheduling to reduce overwork without compromising the staff available to care for patients.
• Post wait times online and in the waiting room or allow people to schedule ER visits (for less emergent issues).
• Improve cross-department collaboration and communication strategies.
• Increase access to primary care services with more flexible appointment scheduling and physicians knowledgeable in emergency medicine.
• Present urgent care as a viable alternative in appropriate situations.

Finding solutions to ER challenges is an ongoing concern that needs regular attention to ensure better outcomes. Choose emergency medicine conferences as part of your continuing medical education (CME) to stay updated on the latest advancements and best practices.