ED Crowding

Crowding is the most important problem facing Emergency Departments worldwide. In the UK crowding in EDs is worsening. The visible effects are ambulances queuing outside emergency departments, trolleys on corridors within EDs, and long waits in EDs both to be seen and to be transferred out to a ward. The invisible effects are the harm caused to both patients and staff. This page contains some links to useful resources on crowding.

Key RCEM information and guidance

• ED crowding overview and toolkit - Dec 2015
• Exit Block Campaign and videos
• RCEM Crowding Guideline (2015)

External Resources

• NHS Improvement Emergency Flow Improvement Tool
• Video on crowding from the Leicester hospitals
• What's behind the A&E 'crisis' - document from the Nuffield Trust
• Monitor report: A&E delays: why did patients wait longer last winter?
• NHS England: Safer, faster, better: good practice in delivering urgent and emergency care
• Scottish Government: ED Capacity Management Guidance
• NHS Operational resilience and capacity planning

Useful UK papers on crowding

• Ian Higginson: Emergency department crowding
• Zoe Morris: Emergency department crowding: towards an agenda for evidence-based intervention
• Adrian Boyle: Emergency Department Crowding: Time for Interventions and Policy Evaluations
• University of York Centre for Reviews and Dissemination: triage and minimising crowding

Position statements from around the world

• Australasian College of Emergency Medicine
• American College of Emergency Physicians
• Canadian Association of Emergency Physicians