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Summer 2006 |
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H
e a l t h T e c h n o l o g y
Report sheds
light on emergency department overcrowding
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Submitted Photo |
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CADTH recently published a
four-part health technology assessment series, which is the most
comprehensive review of emergency department overcrowding ever
conducted in Canada.
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Submitted Article |
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The Canadian Agency for Drugs and
Technologies in Health (CADTH), formerly known as the Canadian
Coordinating Office for Health Technology Assessment (CCOHTA),
recently published a four-part health technology assessment series,
which is the most comprehensive review of emergency department (ED)
overcrowding ever conducted in Canada. It is designed to help
Canadian policy makers, hospital and ED administrators, and
researchers to better understand the nature of ED overcrowding and
what can be done to address this issue.
ED overcrowding is commonly discussed but
its solutions are not well understood. CADTH began a health technology
assessment in 2004 to better understand the factors behind ED
overcrowding in Canada and to look at solutions.
The project was contracted to the
University of Alberta/Capital Health Evidence-based Practice Center (EPC).
It was led by Dr. Brian Rowe, professor, co-director of the EPC, and
research chair of the Department of Emergency Medicine at the University
of Alberta.
The first report, on measuring
overcrowding in EDs, is a national survey and assessment of measures of
overcrowding and their importance to providers of ED services,
administrators and researchers in Canada. A consensus panel of 38 ED
experts identified the most important measures of ED overcrowding. The
top five are: the percentage of EDs occupied by inpatients; the total
number of ED patients; the total time spent in the ED; the percentage of
time when the ED is at or above capacity; and, the overall bed
occupancy.
The second report, which focuses on data
collection of ED patients, examines electronic data collection methods
in hospital EDs, and at the provincial and national levels.
The third report focuses on the frequency,
determinants and impact of overcrowding in EDs. The national survey of
243 ED directors showed that 62 per cent of the 158 respondents saw
overcrowding as a major or severe problem in 2004-2005.
The fourth report is an assessment of the
scientific evidence on interventions designed to address ED
overcrowding. Among the study’s key findings are that fast-track systems
can reduce overcrowding, but their resource and space implications must
be considered; ambulance diversion strategies, short-stay units,
staffing changes and system-wide interventions to reduce overcrowding
should be encouraged and monitored, according to limited evidence; and,
triaging patients is of unproven benefit in reducing overcrowding.
The full emergency department overcrowding
reports can be accessed through CADTH’s new web site at
www.cadth.ca or
through Sheila Tucker, CADTH’s liaison officer for Newfoundland and
Labrador. Ms. Tucker can be reached at (709) 777-8740 or
sheilat@cadth.ca.
On April 3, 2006, the Canadian
Coordinating Office for Health Technology Assessment (CCOHTA) became the
Canadian Agency for Drugs and Technologies in Health (CADTH), a name
which better reflects the breadth of services offered by this
pan-Canadian organization. CADTH is an independent, not-for-profit
agency dedicated to supporting informed decision making in health care.
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