Emergency Department overcrowding - research

The February 6 issue of MJA also has some fascinating articles on ED's - demand, overcrowding and best practice.  Included are the following:

• Emergency department overcrowding, mortality and the 4-hour rule in Western Australia concludes that the introduction of the 4-hour rule in WA led to a reversal of overcrowding in three tertiary hospitals, coinciding with a significant fall in the overall mortality rate in the tertiary hospital data combined. However, there was no reduction in adjusted mortality rates in three secondary hospitals where the improvement in overcrowding was minimal.
• Demand at the emergency department front door: 10-year trends in presentations asks, do demographic changes alone explain our busy EDs?  The study showed that the rise in presentation numbers and presentation rates was beyond that expected from demographic changes. Current models of emergency and primary care are failing to meet community needs.
• Emergency and acute medical admissions: insights from US and UK visits by a Melbourne tertiary health service looks at overseas innovations as the authors visited 13 EDs in the US and the UK.  Ideas included removing triage from reception and avoiding the ED altogether by directly admitting to the wards.

Again, use CIAP or contact your library to obtain the fulltext of these articles.