Emergency room overcrowding: causes and cures

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  • Dorothy Rockwell says:

    Dated man applying for CEO at hsptl in Sav’h, GA. Told me CEO’s tell doctors, load up beds. Make up things to get em in a room. LIE! I’m a Type 1 diabetic, unconscious with a severe hypo diabetic event. Down in the 30s. Had event last night and told ER, I was a RN, after EMS took me to hospital. Never say RN when a pt. My husband has a PHD in Operations Mgt and Info Systems. More education than CEO’s of hospitals in country. Held for 5 hours – for what? No food or water. Only checked twice and griped. Started raising heck. Room filthy, dirt on phone, trash no nursing assts. and RN said only 1 dr. There was two drs. Yelled – why aren’t you working? Load of errors and mgt. negt. Not much room left. Hope this makes sense. Medicine is about money, not pt care, all PROFIT! To heck with pt. My vet treats my pets better than ER! No discharge communication except thyroid high. Nothing on diabetes. Am I mad? Heck YEA! Ashamed to be RN, ashamed to be Journalist. World gone mad! Out of room, list of things ER did was beyond bad. Refuse to pay. What say you?

  • tazret says:

    ED packing is characterized as a circumstance in which the interest for crisis administrations surpasses the capacity of doctors and attendants to give quality consideration inside a sensible time.

  • Flora Knight says:

    I see the problem of overcrowding in the ED as threefold. The first problem is that GPs are not available afterhours or on weekends so patients are advised to go the ED department for emergency care (in many cases not the case). In the UK GPs when not available must provide coverage for their patients by another GP. The second problem is the lack of Long Term Care beds despite the increase in the numbers of senior in our province. The Provincial Government should use the information from Statistics Canada in providing more Long Term Care facilities as the situation will only get worse. Many acute care beds in our hospitals are being occupied by seniors while waiting for a bed in a Long Term Care Facility. The third problem is due to the budget cuts and laying off of nurses in many of our hospitals. Perhaps it is time for the Provincial Auditor General to do an audit of the state of care in hospitals across the province and make recommendations to the government as I do not foresee any change in the present unacceptable situation.

  • Etienne O'Connor - Strata Health says:

    I could not agree more. Having worked in the ED for a few years and now representing a solution that helps drive down ALC rates by 50% within the first year this is dear to my heart. I am happy to chat about this. Can be reached at

  • Franklin Warsh says:

    The entire debate over ER crowding has become surreal in its willful ignorance over LTC capacity. Unlike hospital beds and even home care, where demand will always catch up an expansion of capacity within time, there is an upper limit to the number of LTC beds we need. People that don’t want or need LTC don’t go into LTC, so once the backlog is cleared it’s cleared. And yet there’s still this fixed belief that we can penny-pinch and micro-manage the problem away.

  • Jennifer Dee says:

    Patient flow and availability of hospital beds for admission, is frequently a problem in the ER on long weekends and special holidays like Christmas or Thanksgiving. It is really hard for me to watch a complex care individual being wheeled in from the ambulance bay; I immediately pray for them to survive their latest excursion to the ER. These patients who have complex needs often do not have a comprehensive care plan that is easily accessible and always current (electronic health record). Some of these patients are unloaded and left in the waiting room to become progresively more fragile as the wait time unfolds. I do not envy the patient or the care provider in this case. Canadians have a fragmented system that has too many levels of government to answer to, and resources that are consumed by duplication of tests and services. The system will not be fixed by minor changes, we all need to demand that stakeholder self-interest does not prevent us from inovating and making bold and courageous changes to the health care offered across the nation.

  • Frustrated says:

    “An example of that is the rising number of patients who are in hospital despite not needing hospital level of medical care. Rather, they’re waiting for long-term care, respite beds, rehabilitation beds, or other supports before being sent home. These patients are formally designated as “alternative level of care,” or ALCs. ALCs make up about 13 percent of patients in acute care beds across Canada.”

    As Yogi Berra would say, it’s deja vu all over again:

    Tired of hearing this talking point again… and again… and again. Look forward to reading next year’s article on the “ALC problem”. The politics of the the “ALC problem” are obviously quite favourable as it has worked so remarkably well since at least the George Smitherman days.

    I wish “our” physician leaders (i.e., Joshua Tepper) would actually hold government to account for a change, but maybe the pay is too good. You know, call them out when the track record on the “ALC problem” is clearly a heap of garbage with the odd sexy pilot project that never amounts to anything and serves as a distraction from making meaningful investments that will actually make a difference for patients and burned out front line staff.


Vanessa Milne


Vanessa is a freelance health journalist and a form staff writer with Healthy Debate

Joshua Tepper


Joshua Tepper is a family physician and the President and Chief Executive Officer of North York General Hospital. He is also a member of the Healthy Debate editorial board.

Jeremy Petch


Jeremy is an Assistant Professor at the University of Toronto’s Institute of Health Policy, Management and Evaluation, and has a PhD in Philosophy (Health Policy Ethics) from York University. He is the former managing editor of Healthy Debate and co-founded Faces of Healthcare

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