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Member Research and Reports

Member Research and Reports

UNC: Emergency Department Crowding Hospital-Wide Problem

Overcrowded hospital emergency departments (ED) can have negative consequences on patient health and hospital performance, but when it comes to solutions to ease gridlock in the ED, one size does not fit all.

New research from Dr. Amir Alishahi, a recent graduate from the Department of Health Policy and Management at the University of North Carolina Gillings School of Global Public Health, finds that without hospital-wide interventions and a culture that recognizes ED overcrowding as a hospital-wide issue, most efforts will not have a significant impact on the problem.

Dr. Alishahi is lead author of two new papers on the topic: “Association between adopting emergency department crowding interventions and emergency departments’ core performance measures,” published in the April issue of American Journal of Emergency Medicine, and “What is full capacity protocol, and how is it implemented successfully?” published July 18 in Implementation Science.

Other Gillings School faculty on these projects are Drs. Justin Trogdon, Bruce Fried, Christopher Shea and Sarah Birken.

In the first paper, Dr. Alishahi and his team analyzed data from 1.18 billion ED visits in the United States between 2007 and 2015. They found that the number of visits has increased by about 24 percent in that time — four times faster than U.S. population growth.

For the second project, Dr. Alishahi’s team studied the adoption and implementation of full capacity protocol (FCP), an ED crowding intervention determined by the previous study to be one of the most effective. FCP transfers select patients (who have been admitted to the hospital but, due to a lack of available beds on the inpatient units, are still boarding in ED hallways) to board in the inpatient unit hallways instead.

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