Causes and Solutions for Emergency Department Crowding: A Qualitative Study of Healthcare Staff Perspectives

Introduction: Emergency Department (ED) crowding is a major problem globally. This situation leads to many negative consequences such as long waiting time, decreased satisfaction of patients and healthcare staff, delay in treatment of patients most in need of emergency care, decrease in the quality of healthcare provided and increase in healthcare costs. The aim of this study is to determine why patients prefer to use the ED, to identify the current problems of ED services and to develop solutions from the perspectives of ED healthcare staff in order to alleviate the ED crowding and related problems. Methods: This study utilised a qualitative approach. In-depth semi-structured interviews were conducted with 22 ED healthcare staff between 20th December 2021 and 18th February 2022. Thematic analysis method was performed to analyse the data. Results: Twenty-two ED healthcare staff were interviewed; 16 were male and 6 were female. ED healthcare staff interviews were conducted with 14 ED nurses, 6 ED doctors, and 2 ED consultants, who had at least 1-year of work experience in the ED, without any consideration of their gender or age. As a result of the data analysis, five main themes emerged: Insufficient healthcare system, patient-related problems, advantages of EDs, consequences of ED crowding, and solutions for ED crowding. Conclusion: Insufficient healthcare system, advantages of ED, and patients’ perceptions about using healthcare services led patients to use ED and subsequently to the ED crowding. There is a need for effective solutions to alleviate ED crowding. The precautions to reduce non-urgent ED visits are not enough. Many factors need to be considered and all of them should be applied together accordingly.