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Nurs. Clin. North Am. · Mar 2002
ReviewOvercrowding and diversion in the emergency department: the health care safety net unravels.
- George D Velianoff.
- Emergency Nurses Association, 915 Lee Street, Des Plaines, IL 60016, USA. gvelianoff@ena.org
- Nurs. Clin. North Am. 2002 Mar 1;37(1):59-66, vi.
AbstractEmergency department overcrowding and diversion of patients are serious problems that are symptomatic of larger health care system issues. Downsizing, government regulations, managed care, increased numbers of uninsured, and reimbursement decreases are issues that have created the overcrowding and diversion issues. The Emergency Medical Treatment and Active Labor Act (EMTALA), poor operations and hospital processes, unavailable inpatient beds and closures, consolidations and workforce shortages are also contributors to the overcrowding and diversion issues. Options and solutions are proposed to alleviate the problem, however, greater collaboration, changed work environments, and reimbursement structures need to be developed and instituted. The safety net of the US health system is unraveling, and without intervention, the emergency department will not be able to provide services to the public at any level of quality and efficiency.
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