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Emergency department crowding: A systematic review of causes, consequences and solutions


Morley, C and Unwin, M and Peterson, GM and Stankovich, J and Kinsman, L, Emergency department crowding: A systematic review of causes, consequences and solutions, PLoS One, 13, (8) Article e0203316. ISSN 1932-6203 (2018) [Refereed Article]


Copyright Statement

Copyright 2018 Morley at al. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

DOI: doi:10.1371/journal.pone.0203316


Background: Emergency department crowding is a major global healthcare issue. There is much debate as to the causes of the phenomenon, leading to difficulties in developing successful, targeted solutions.

Aim: The aim of this systematic review was to critically analyse and summarise the findings of peer-reviewed research studies investigating the causes and consequences of, and solutions to, emergency department crowding.

Method: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A structured search of four databases (Medline, CINAHL, EMBASE and Web of Science) was undertaken to identify peer-reviewed research publications aimed at investigating the causes or consequences of, or solutions to, emergency department crowding, published between January 2000 and June 2018. Two reviewers used validated critical appraisal tools to independently assess the quality of the studies. The study protocol was registered with the International prospective register of systematic reviews (PROSPERO 2017: CRD42017073439).

Results: From 4,131 identified studies and 162 full text reviews, 102 studies met the inclusion criteria. The majority were retrospective cohort studies, with the greatest proportion (51%) trialling or modelling potential solutions to emergency department crowding. Fourteen studies examined causes and 40 investigated consequences. Two studies looked at both causes and consequences, and two investigated causes and solutions.

Item Details

Item Type:Refereed Article
Keywords:emergency department access, hospital
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Health services and systems not elsewhere classified
Objective Division:Health
Objective Group:Other health
Objective Field:Other health not elsewhere classified
UTAS Author:Morley, C (Dr Claire Morley)
UTAS Author:Unwin, M (Dr Maria Unwin)
UTAS Author:Peterson, GM (Professor Gregory Peterson)
UTAS Author:Stankovich, J (Dr Jim Stankovich)
UTAS Author:Kinsman, L (Professor Leigh Kinsman)
ID Code:128080
Year Published:2018
Web of Science® Times Cited:374
Deposited By:Health Sciences
Deposited On:2018-08-31
Last Modified:2019-09-10
Downloads:237 View Download Statistics

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