Emergency Department Overcrowding

Contributing Factors and Interventions 

Emergency department (ED) overcrowding is a complex systems-wide issue resulting from multiple interconnected factors across various levels of the health system and beyond. Solutions to help alleviate ED overcrowding should target the underlying factors contributing to the issue in a specific context.

CADTH identified factors described in the published literature that contribute to ED overcrowding and summarized systematic review evidence on the effectiveness of different interventions to alleviate ED overcrowding. CADTH produced a report on both of these components, which decision-makers can use to help identify factors and interventions when ED overcrowding occurs. 

Key Messages

  • Most factors exist either outside the ED or at the interface of the ED and other health care services; whereas most of the interventions CADTH identified existed within the ED.
  • Several interventions were identified that might help alleviate ED overcrowding. Examples of effective interventions include:
    • prehospital decision-making by first responders
    • short-stay crisis units for people experiencing mental health challenges
    • care strategies to help people after they leave the hospital
    • time-based policy reforms.

Contributing Factors and Interventions Effectiveness

Supporting Information: Contributing Factors and Intervention Effectiveness