Improving Patient Flow and Reducing Emergency Department Crowding: A Guide for Hospitals


1. Diercks DB, Roe MT, Chen AY, et al. Prolonged emergency department stays of non-ST-segment-elevation myocardial infarction patients are associated with worse adherence to the American College of Cardiology/American Heart Association guidelines for management and increased adverse events. Ann Emerg Med 2007; 50(5):489-496.

2. Fee C, Weber EJ, Maak CA, Bacchetti P. Effect of emergency department crowding on time to antibiotics in patients admitted with community-acquired pneumonia. Ann Emerg Med 2007; 50(5):501-509.e1.

3. Schull MJ, Vermeulen M, Slaughter, G, et al. Emergency department crowding and thrombolysis delays in acute myocardial infarction. Ann Emerg Med 2004; 44(6):577-585.

4. Hwang U, Richardson L, Livote E, et al., Emergency department crowding and decreased quality of pain care. Acad Emerg Med 2008; 15(12):1248-1255.

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11. National Quality Forum endorses measures to address care coordination and efficiency in hospital emergency departments. Press release, October 29, 2008. Washington, DC: National Quality Forum; 2008.

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16. Improving Patient Flow & Reducing Emergency Department Crowding. Washington, DC: The George Washington University School of Public Health and Health Services; February 2010.

17. Silow-Carroll, Alteras, T., and Meyer, J.A. Hospital Quality Improvement: Strategies and Lessons from U.S. Hospitals. New York: Commonwealth Fund; April 2007. Available at

18. Timmel J, Kent PS, Holzmueller CG, et al. Impact of the Comprehensive Unit-Based Safety Program (CUSP) on safety culture in a surgical inpatient unit. Jt Comm J Qual Patient Saf 2010; 36(6):252-260.

19. Science of Improvement: Forming the Team. Washington, DC: Institute for Healthcare Improvement; 2011.

20. McCaig LF, Xu J, Niska RW. Estimates of Emergency Department Capacity: United States, 2007. Hyattsville, MD: National Center for Health Statistics; 2009. Available at [Plugin Software Help]. Accessed October 17, 2011.

21. McClelland MS, Jones K, Siegel B, Pines J. A field test of time-based emergency department quality measures. Ann Emerg Med 2011; epub.

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Page last reviewed October 2018
Page originally created September 2012
Internet Citation: References. Content last reviewed October 2018. Agency for Healthcare Research and Quality, Rockville, MD.
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