Does a Larger ED Provide Relief from Overcrowding?

Although the causes of emergency department overcrowding are myriad, the solution will require an increase in ED capacity, either by building larger EDs, changing the way in which patients are processed, or both. In a computer simulation, researchers compared the effect on ED length of stay of increasing the number of ED beds and increasing the departure rate of patients admitted to the hospital (ED boarders). The baseline model had a 23-bed ED and an ED boarder departure rate of one patient every 20 minutes.

Increasing the number of ED beds by 22% (from 23 to 28), with no other change, increased mean ED stay from 240 to 247 minutes. Increasing the ED boarder departure rate by 25% (from 1 patient every 20 minutes to 1 patient every 15 minute…