Adoption of Interventions to Address ED Crowding, 2007–2010

Several interventions (such as bedside registration, use of a fast track, and boarding of patients in inpatient, rather than emergency department [ED] hallways) have been shown to decrease ED crowding and to improve efficiency and patient safety. The National Hospital Ambulatory Medical Care Survey (NHAMCS) — a longitudinal probability sample of U.S. ED visits — began measuring adoption of 17 such interventions in 2007. Using NHAMCS data, these authors assessed adoption of each intervention in relation to ED crowding. Participating hospitals were categorized into quartiles of crowding based on median ED length of stay.

Between 2007 and 2010, the average number of interventions adopted increased from 5.2 to 6.6, with more-crowded EDs adopting…