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United StatesSome ED facts from a Centers for Disease Control media brief dated September 27, 2006, using stats from 2003–2004: • During the period, an
average of 4,500 EDs were in operation in United
States.
• More than half of EDs
saw fewer than 20,000 patients annually, but one
out of 10 had an annual visit volume of more than
50,000 patients.
• 40-50% of US hospitals
experience crowded conditions in the ED, with almost
two-thirds of metropolitan EDs occasionally experiencing
crowding. Approximately one-third reported having
to divert an ambulance to another emergency department
due to overcrowding or staffing shortages at their
ED. (According to a paper
published in the September 28 issue of The
New England Journal of Medicine, in
2003, ambulance diversions occurred more than half
a million times – an average of once per minute!)
• Crowding in metropolitan
EDs was associated with a higher percentage of nursing
vacancies, higher patient volume, and longer patient
waiting and treatment durations.
• Most EDs used outside
contracts to provide physicians (64.7%).
• Half of EDs in metropolitan
areas had more than 5% of their nursing positions
vacant. CanadaStatistics Canada reported that, in 2003, 3.3 million people, or one out of every eight Canadians aged 15 or older, had their most recent contact with a health professional, or treatment for an injury, in a hospital ER. And some facts from a survey of ED directors published in May 2006, and conducted by the Canadian Agency for Drugs and Technologies in Health: • 62% of responding ED
directors saw overcrowding as a major or severe problem
in 2004–2005.
• Major or severe overcrowding
is much more likely to occur in EDs with more than
50,000 visits per year and with 30 or more treatment
spaces, in communities with a population of at least
150,000, at university-affiliated hospitals, and
at trauma centers.
• 85% of respondents perceive
that the lack of available beds for admitted patients
is a major or serious cause of overcrowding.
• 82% of ED directors perceive
that overcrowding impacts the stress level among
nurses; 68% feel it affects nursing staff recruitment
and retention; 66% feel it impacts ED staff satisfaction;
65% feel it increases stress among physicians; 79%
feel it has a major or serious impact on ED wait
times; and 52% think it increases the risk of poor
patient outcomes.
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