How Emergency Room Clinicians Are Dealing with Overcrowding

A majority of  assachusetts hospitals have faced significant ER overcrowding problems in recent years. The overcrowding has led to significant expansion projects in nearly every corner of the state. Yet even as hospitals seek to increase the square footage of their emergency departments, clinicians on the ground are discovering new ways to deal with overcrowding.

It would seem that overcrowding is the norm in U.S. hospitals. For whatever reason, the number of hospital visits for non-emergencies has spiked in the last decade, leaving emergency departments designed to handle only so many patients scrambling to find space for more.

A good example is Brigham and Women’s Hospital in Boston. They are in the initial stages of a $52 million expansion that will double the floor space and add 30 new beds. That’s a start, according to proponents of the plan. In the meantime, what are emergency department doctors and nurses doing to make use of the space they have?

Utilizing Hallways and Corridors

The Boston Globe reports that clinicians throughout Massachusetts are beginning to treat patients in halls and corridors. They simply have support staff set up cots and then go from there. While the solution is not ideal, clinicians say it’s one way to get more patients treated before they simply give up in frustration and walk out.

It’s worth noting that doctors and nurses are not treating critical patients in hallways and corridors. The temporary beds are reserved for minor cases that don’t require advanced care. The benefit here is that it saves the traditional rooms and beds for those patients who truly need them.

Training in Mental Illness and Drug Abuse

Statistics show that increasing numbers of emergency room patients are coming in with issues related to mental illness and/or drug abuse. So to help themselves more effectively treat these patients, clinicians are undergoing further training designed to bring them up to speed.

In the past, an ER doctor would have thought nothing of contacting a staff psychiatrist to help deal with a patient suffering from mental illness. Today it is more likely that the same doctor has undergone additional training and is now happy to treat the patient without additional consultation.

Referring Patients to Urgent Care

Another helpful strategy is to refer non-critical patients to urgent care centers. Such referrals can be either immediate or simply suggestions to visit urgent care next time a medical need arises. It is a strategy more hospitals are encouraging their doctors to practice in order to ease overcrowding.

In the meantime, growing numbers of hospitals are starting to partner with urgent care centers to take less critical cases before patients ever arrive at the ER. Exactly how those partnerships function isn’t quite clear. What is clear is that urgent care centers can take some of the load away from overcrowded hospital ERs.

Creative Solutions to Complex Problems

If there is a silver lining in emergency room overcrowding it is the fact that it is forcing hospitals and clinicians alike to come up with creative solutions to complex problems. The situation is a lot like a locum tenens clinician entering a brand-new environment for the first time. He or she has to figure out how things are normally done while at the same time looking for the most creative ways to contribute.

There is no simple solution to ER overcrowding. But everyone involved is working on it. And in Massachusetts, the combined answer includes expanding emergency room facilities, referring more patients to urgent care, new training for doctors, and a willingness to utilize every inch of available space.