Another Look at the Persistent Moral Problem of Emergency Department Crowding
Another Look at the Persistent Moral Problem of Emergency Department Crowding
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DOI：
10.1016/j.annemergmed.2018.11.029
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发表时间：
2019-09-01
影响因子：
6.2
通讯作者：
Iserson, Kenneth V.
中科院分区：
文献类型：
--
作者：
Moskop, John C.;Geiderman, Joel M.;Iserson, Kenneth V.
本文重新审视了美国医院急诊室（ED）持续存在的拥挤问题。它首先简要回顾了这个问题的起源，术语用来指艾德拥挤，拥挤的定义和措施，以及因果关系。文章总结了最近的研究，记录不良的道德后果的艾德拥挤，包括病人的结果较差，增加医疗差错，在病人的身体隐私，保密性和沟通的妥协，和供应商的道德困扰。它描述了几种组织策略，以减轻拥挤和影响的艾德拥挤的个人从业者。文章的结论是，艾德拥挤仍然是一个道德上重要的问题，并呼吁急诊医生，艾德和医院领导，急诊医学专业协会和政策制定者合作的解决方案。
This article revisits the persistent problem of crowding in US hospital emergency departments (EDs). It begins with a brief review of origins of this problem, terms used to refer to ED crowding, proposed definitions and measures of crowding, and causal factors. The article then summarizes recent studies that document adverse moral consequences of ED crowding, including poorer patient outcomes; increased medical errors; compromises in patient physical privacy, confidentiality, and communication; and provider moral distress. It describes several organizational strategies implemented to relieve crowding and implications of ED crowding for individual practitioners. The article concludes that ED crowding remains a morally significant problem and calls on emergency physicians, ED and hospital leaders, emergency medicine professional associations, and policymakers to collaborate on solutions.