Overcrowding in hospitals can cause patients to wait longer for care, and it increases the likelihood of medical errors. It also makes it more difficult to screen patients for covid-19 or other infectious diseases. This is because staff must focus on assessing the most urgent patients first, leaving less time for other screening or tests.
The primary causes of hospital overcrowding are mismatched bed supply and poor flow of patients through the system. Hospitals may be unable to transfer outpatients into skilled nursing facilities or other care settings, creating a bottleneck that prevents ED beds from opening up. Hospitals are also unable to increase throughput by constructing new inpatient units or modifying existing ones because any changes require long-winded and expensive state approval processes.
Internal department improvements such as bedside registration and efficient use of hospitalists can help decrease boarding and crowding, but additional solutions are needed on the macrolevel to improve capacity, reduce ED boarding, preserve nurse/patient ratios and increase ICU access. One solution is to smooth the timing of elective (schedulable) admissions, which can decrease ED boarding and free up beds for high-cost inpatient procedures that generate more revenue.