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System Dynamics and Dysfunctionalities: Levers for Overcoming Emergency Department Overcrowding
Author(s) -
Schiff Gordon D.
Publication year - 2011
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.2011.01225.x
Subject(s) - overcrowding , underinsured , medicine , dysfunctional family , emergency department , medical emergency , health care , primary care , crowding , nursing , family medicine , health insurance , psychiatry , economic growth , economics , neuroscience , biology
ACADEMIC EMERGENCY MEDICINE 2011; 18:1255–1261 © 2011 by the Society for Academic Emergency Medicine Abstract Overcrowding of U.S. emergency departments (EDs) is a widely recognized and growing problem. This presentation offers the perspectives of a primary care physician (PCP) examining the problem at three levels: global health policy, quality process improvement, and more intimate clinical caring. It posits that ED overcrowding is actually a symptom of 10 more fundamental problems in U.S. health care and EDs: variations/supply‐demand mismatch; primary care provider shortfalls; limited after‐hours access; admission throughput challenges; clinical challenges related to discontinuity patients; clinical challenges related to those with special needs; interruptions; testing logistical challenges; suboptimal information systems; and fragmented/dysfunctional health insurance system, leaving many un‐ and underinsured.