Emergency Department Overcrowding in Canada: Multistakeholder Dialogue

Tamara Rader, Lindsay Ritchie
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 During 3 multistakeholder dialogue sessions, patients, families, community members, emergency department (ED) staff and trainees told us that ED overcrowding results from a wider health care system dysfunction. They communicated that a major driving force is hospitals operating at or over capacity and large proportions of alternate level of care patients unable to be discharged due to lack of long-term care spaces.
 We heard that an absence of health care resources available within communities could worsen the problem by filling the ED with patients who could be managed more appropriately elsewhere. Participants described how this creates frustration among patients and families and can contribute to staff burnout and moral distress.
 Participants suggested that to effect change, solutions need to address accountability and incorporate integration across the health care systems. We heard that the specific health needs of patients and families should drive decision-making about solutions.
 Participants described that currently available technologies and data are not being used to their full potential.
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Abstract

During 3 multistakeholder dialogue sessions, patients, families, community members, emergency department (ED) staff and trainees told us that ED overcrowding results from a wider health care system dysfunction. They communicated that a major driving force is hospitals operating at or over capacity and large proportions of alternate level of care patients unable to be discharged due to lack of long-term care spaces. We heard that an absence of health care resources available within communities could worsen the problem by filling the ED with patients who could be managed more appropriately elsewhere. Participants described how this creates frustration among patients and families and can contribute to staff burnout and moral distress. Participants suggested that to effect change, solutions need to address accountability and incorporate integration across the health care systems. We heard that the specific health needs of patients and families should drive decision-making about solutions. Participants described that currently available technologies and data are not being used to their full potential.
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加拿大急诊科过度拥挤:多方利益攸关方对话
& # x0D;在3次多方利益相关者对话会议上,患者、家属、社区成员、急诊科(ED)工作人员和受训人员告诉我们,急诊科人满为患是卫生保健系统功能失调的结果。他们表示,一个主要的推动力是医院满负荷运转或超负荷运转,而且由于缺乏长期护理空间,很大比例的替代级别护理患者无法出院。我们听说,社区内缺乏可用的卫生保健资源可能会使问题恶化,因为急诊科塞满了可以在其他地方得到更适当管理的病人。与会者描述了这如何在患者和家属中造成沮丧,并可能导致工作人员倦怠和道德困境。与会者建议,要实现变革,解决方案需要解决问责问题,并纳入整个卫生保健系统的整合。我们听说,患者和家属的特殊健康需求应该推动解决方案的决策。与会者描述说,目前可用的技术和数据没有充分发挥其潜力。
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