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Invited Commentary
November 2014

Overcrowded Emergency Departments: Is Sunlight Enough of a Disinfectant?

Author Affiliations
  • 1Department of Emergency Medicine, Brigham & Women’s Hospital, Boston, Massachusetts
  • 2Department of Medicine, Harvard Medical School, Boston, Massachusetts
JAMA Intern Med. 2014;174(11):1846-1847. doi:10.1001/jamainternmed.2014.1174

Despite devoting immense resources to emergency preparedness since the September 11, 2001, terrorist attacks, many US emergency departments (EDs) remain crowded, with patients in the waiting room awaiting a complete physician evaluation and acutely ill “boarding”—being held in the ED for a bed to open up on the hospital wards. Le and Hsia1 analyzed data on ED timeliness from the Centers for Medicare & Medicaid Services (CMS) and found that the median US hospital has a 29-minute ED waiting time and an 85-minute boarding time. One quarter of EDs had median wait times in excess of 41 minutes, the longest wait time being 14 hours, and median boarding times in excess of 2 hours, the longest being 46 hours. These “worst” performers are likely to be large, urban, public, or teaching hospitals. Each hospital would tell the story of an ED striving to serve a critical community need, such as trauma care, or as a safety net to those without access, but struggling to do so in a timely fashion.

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