Streamlined hospital emergency room symbolizing efficient patient flow.

Easing the Squeeze: Practical Steps to Reduce Hospital Crowding

Elliot Brynn in Health & Wellness December 2025 • 4 min read.

"Discover how simple, hospital-wide interventions can significantly cut down emergency department wait times and improve patient care."

Emergency department (ED) crowding is a critical issue threatening the efficiency and effectiveness of healthcare systems. This problem arises primarily from delays in patient processing, especially after initial medical care is complete, as patients await consultation, admission, or transfer to other parts of the hospital. Multiple interventions, both within and outside the ED, have been proposed, but their effectiveness can vary widely.

A recent study highlighted in the American Journal of Emergency Medicine sheds light on practical strategies for tackling ED crowding. The focus is on implementing organizational changes that promote better coordination and accountability across the entire hospital. Such measures are essential for making substantial progress in reducing post-emergency care delays.

The study underscores the impact of simple interventions, demonstrating how they can lead to significant improvements. By adopting a hospital-wide approach, healthcare facilities can enhance patient flow, reduce wait times, and improve the overall quality of care.

The Power of Simple Changes: How Two Key Interventions Can Transform Your ED

Streamlined hospital emergency room symbolizing efficient patient flow.

A recent paper by Huang illustrates how two straightforward interventions can deliver remarkable and sustainable results in reducing ED length of stay (LOS). Specifically, the study reported a 42% reduction in ED LOS for a subset of patients, highlighting the potential for simple changes to drive significant improvements in healthcare efficiency and patient outcomes.

These interventions hinge on the cooperation of various hospital departments beyond the ED. The first involves direct referrals from ED physicians to inpatient teams, streamlining the admission process and minimizing delays. The second focuses on making beds readily available in the Clinical Decision Unit (CDU). While this may require some resource allocation, it reflects responsible practice and ensures that patients can be moved to appropriate care settings without unnecessary delays.

Direct Referrals: Allows ED physicians to directly contact inpatient teams, expediting patient transfers.
CDU Bed Availability: Ensures that the Clinical Decision Unit has beds ready, facilitating quicker patient transitions.

These simple steps represent a practical approach to reducing ED crowding. By identifying and minimizing bottlenecks within the system, hospitals can enhance the quality of care and improve patient experiences. This incremental, quality-improvement approach is particularly beneficial for high-resource patients, such as those with trauma, who require extensive care and are more susceptible to adverse events caused by delays.

Looking Ahead: Building on Success to Enhance ED Function

The study serves as a positive step toward alleviating ED crowding and underscores the importance of hospital-wide cooperation in driving meaningful change. By demonstrating real improvements in patient flow, healthcare facilities can foster a culture of continuous improvement and extend these benefits to a broader patient population. The challenge lies in scaling these successful interventions to ensure that all patients receive timely and efficient care, thereby enhancing the overall effectiveness of the ED.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.ajem.2018.08.006, Alternate LINK

Title: Progress Towards Reducing Crowding

Subject: Emergency Medicine

Journal: The American Journal of Emergency Medicine

Publisher: Elsevier BV

Authors: Drew Richardson

Published: 2018-10-01

Everything You Need To Know

What exactly is the problem of Emergency Department (ED) crowding?

Emergency Department (ED) crowding is a critical issue in healthcare, primarily caused by delays in patient processing. These delays often occur after initial medical care is complete, as patients wait for consultations, admissions, or transfers. This crowding can severely impact the efficiency and effectiveness of healthcare systems, potentially leading to longer wait times and reduced quality of care for patients. It is the root cause of the problems that the proposed solutions attempt to fix.

What are the main solutions proposed to alleviate Emergency Department (ED) crowding?

The study emphasizes two key interventions. The first is direct referrals, allowing ED physicians to contact inpatient teams directly, streamlining the admission process. The second is ensuring the Clinical Decision Unit (CDU) has beds available to facilitate quicker patient transitions. These simple steps, when implemented together, can significantly reduce the Emergency Department (ED) length of stay (LOS) and improve patient flow throughout the hospital.

How do direct referrals from the Emergency Department (ED) help reduce wait times?

Direct referrals from Emergency Department (ED) physicians to inpatient teams streamline the admission process. This means instead of going through multiple layers of communication, the ED doctor can directly contact the inpatient team, reducing the time it takes to move a patient to the appropriate care setting. This quicker transfer helps to alleviate crowding and improve the overall efficiency of the ED, as it reduces bottlenecks in patient flow.

Why is ensuring bed availability in the Clinical Decision Unit (CDU) important?

The Clinical Decision Unit (CDU) is essential because it provides a designated space for patients who need further observation or treatment but do not require full inpatient admission. Ensuring the CDU has available beds allows for quicker transitions from the Emergency Department (ED), preventing patients from unnecessarily occupying ED beds. This practice is part of a hospital-wide approach to enhance patient flow, reduce wait times, and improve care quality, especially for high-resource patients.

Why is this study important in the context of improving Emergency Department (ED) function?

The study is significant because it demonstrates that practical, hospital-wide interventions can produce substantial improvements in Emergency Department (ED) efficiency. The 42% reduction in ED Length of Stay (LOS) for certain patients highlights the impact of these simple changes. This provides a model for other hospitals to adopt similar strategies, promoting a culture of continuous improvement and enhancing the overall effectiveness of the ED, ultimately leading to better patient outcomes.