As emergency departments throughout the country deal with the problems of crowding, boarding, and ambulance diversion, solutions have been sought. The resources on this page provide information, resources and examples of a variety of approaches to assist emergency physicians in addressing the crowding problems by working with hospital administrators, local stakeholders, policy makers and the public. Some ACEP chapters have sought relief through state legislative and regulatory action. These additional crowding resources are available in ACEP's Advocacy area.
Emergency Department Crowding: High-Impact Solutions
This comprehensive 2008 report from the ACEP Boarding Task Force includes low and no-cost solutions to the practice of boarding patients in the emergency department. ACEP members get free CME.
ACEP’s Suggested Boarding Solutions Generate National Support
May 30, 2008
Information Papers
Optimizing ED Front End Operations, February 2010
Approaching Full Capacity in the Emergency Department, October 2006
Meeting the Challenge of Emergency Department Overcrowding/Boarding, Report from a Roundtable Discussion, 2005
Emergency Department Crowding, March 2004
Emergency Department Operations Management, March 2004
Comprehensive Guides
Perfecting Patient Flow: America’s Safety Net Hospitals and Emergency Department Crowding, 2005
Responding to Emergency Department Crowding: A Guide Book for Chapters, August 2002
Reference Articles
Crowding and Surge Capacity Resources for Emergency Departments, April 2007
This paper includes 63 references to articles on ED Crowding and Quality of Care as well as Surge Capacity.
Online Resources
Managing Non-emergency Care in the Emergency Department
Addressing Surge Capacity in a Mass Casualty Event. March 2006. Agency for Healthcare Research and Quality.
Emergency department utilization and surge capacity in New Jersey, 1998-2003. DeLia D. March 2005.
Medical surge capacity and capability handbook. DHHS Office of Preparedness and Emergency Operations. August 2004.
Surge capacity: Education and training for a qualified workforce. Agency for Healthcare Research and Quality. March 2, 2004.
Hospital and Healthcare Systems – Surge Capacity. Barbisch D. June 2003.
Root cause analysis of emergency department crowding and ambulance diversion in Massachusetts. Emergency room diversion study: Analysis and findings. October 2002.
Letter to Hospital Administrators regarding hospital ED overcrowding. April 8, 2002. NY State Department of Health.
Emergency Departments: An Essential Access Point to Care. AHA TrendWatch, March 2001
Letter to Hospital Administrators regarding hospital ED overcrowding. December 11, 2000. NY State Department of Health.
Hospital overcrowding resources. Created by Peter Viccellio, MD, FACEP.
Lectures/Presentations
Related ACEP Scientific Assembly 2007 presentations
Optimizing Patient Flow in the ED: A Director’s Guide to Efficient ED Operations (MO-72)
Faculty: Michael Shafé, MD, FACEP
Fast and Efficient Practice: The Emergency Department Autobahn (TU-136)
Faculty: Michael Shafé, MD, FACEP
Tackling Emergency Department Crowding: From the Inside Out (TU-141)
Faculty: Stephen A. Colucciello, MD, FACEP, Jay A. Kaplan, MD, FACEP, Sandra M. Schneider, MD, FACEP, Peter Viccellio, MD, FACEP, Richard E. Wolfe, MD, FACEP
Best Practices: From Chaos to Consensus (TH-248)
Faculty: James J. Augustine, MD, FACEP
Reducing Time-to-Provider: Successful Implementation Secrets (TH-291)
Faculty: James J. Augustine, MD, FACEP
Related ACEP Policy Statements
Boarding
Boarding of Admitted and Intensive Care Patients in the Emergency Department
Caring for Emergency Department "Boarders"
Health Care System Surge Capacity Recognition, Preparedness, and Response
Responsibility for Admitted Patients
Writing Admission Orders
Diversion
Ambulance Diversion
PREP for above policy:
Guidelines for Ambulance Diversion
Crowding
Emergency Ambulance Destination
