SynthesisPloS one2018
Emergency department crowding: A systematic review of causes, consequences and solutions.
Synthesis in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 592 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comprehensive Geriatric Assessment in the Emergency Department: a Prospective Cohort Study of Clinical and Process Outcomes
Cost of Emergency Department Boarding for Hospitalized Patients in a Statewide Medical System
Who cites it
592 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- Cost-Effectiveness of Virtual Emergency Care Models: Systematic Review.JMIR mHealth and uHealth · 2026Pooled it
- Scoping review on alternative care options for patients calling the ambulance.BMC emergency medicine · 2026Pooled it
- Emergency department crowding in the modern era: a systematic review (2018-2025).Clinical and experimental emergency medicine · 2026Pooled it
- Interventions to reduce emergency department overcrowding and their effects on patient outcomes: a mixed-methods systematic review and meta-analysis.BMC emergency medicine · 2026Pooled it
- Systematic Review of Interventions to Optimize Emergency Department Care of Patients with Cancer.The western journal of emergency medicine · 2026Pooled it
- Effectiveness and safety of emergency department-based streaming interventions for low-acuity utilizers - systematic review and meta-analysis.BMC emergency medicine · 2026Pooled it
- Pooled it
- Safety and Efficacy of Digital Check-in and Triage Kiosks in Emergency Departments: Systematic Review.Journal of medical Internet research · 2025Pooled it
- The Transition of Care Between Emergency Department and Primary Care: An Integrative Systematic Review.Journal of clinical nursing · 2025Pooled it
- Long versus conventional peripheral intravenous catheters to reduce venipunctures during hospital stay: A randomized controlled trial.The journal of vascular access · 2026Trial
- Data-Driven Implementation Strategy to Optimise Clinician Behaviour Change at Scale in Complex Clinical Environments: A Multicentre Emergency Care Study.Journal of advanced nursing · 2025Trial
- Point-of-care testing improves care timeliness in the emergency department. A multicenter randomized clinical trial (study POCTUR).Clinical chemistry and laboratory medicine · 2025Trial
- Trends in acute specialist contacts following a primary care contact 2012-21-a registry-based study.Scandinavian journal of primary health care · 2026Article
- Telephone triage in urgent unscheduled primary care in 16 European countries: a cross-national questionnaire-based expert study.Scandinavian journal of primary health care · 2026Article
- Article
- Prospective evaluation of a large language model clinical decision support system in the emergency department.Nature medicine · 2026Article
- Patient-Reported Outcome Measures in the Emergency Department: A Scoping Review.Journal of the American College of Emergency Physicians open · 2026Review
- Automatic phenotyping of emergency department patients with incidental hepatic steatosis: A machine learning clustering analysis.The American journal of emergency medicine · 2026Article
- A data-driven digital twin of emergency department flow to quantify congestion dynamics and test operational resilience.Internal and emergency medicine · 2026Article
- Forecast-Driven Dynamic Physician Staffing in a Pediatric Emergency Department: A Prospective Quasi-Experimental Pilot Study.Journal of medical systems · 2026Article
532 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergency department crowding is a major global healthcare issue. There is much debate as to the causes of the phenomenon, leading to difficulties in developing successful, targeted solutions.
aimThe aim of this systematic review was to critically analyse and summarise the findings of peer-reviewed research studies investigating the causes and consequences of, and solutions to, emergency department crowding.
methodThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A structured search of four databases (Medline, CINAHL, EMBASE and Web of Science) was undertaken to identify peer-reviewed research publications aimed at investigating the causes or consequences of, or solutions to, emergency department crowding, published between January 2000 and June 2018. Two reviewers used validated critical appraisal tools to independently assess the quality of the studies. The study protocol was registered with the International prospective register of systematic reviews (PROSPERO 2017: CRD42017073439).
resultsFrom 4,131 identified studies and 162 full text reviews, 102 studies met the inclusion criteria. The majority were retrospective cohort studies, with the greatest proportion (51%) trialling or modelling potential solutions to emergency department crowding. Fourteen studies examined causes and 40 investigated consequences. Two studies looked at both causes and consequences, and two investigated causes and solutions.
conclusionsThe negative consequences of ED crowding are well established, including poorer patient outcomes and the inability of staff to adhere to guideline-recommended treatment. This review identified a mismatch between causes and solutions. The majority of identified causes related to the number and type of people attending ED and timely discharge from ED, while reported solutions focused on efficient patient flow within the ED. Solutions aimed at the introduction of whole-of-system initiatives to meet timed patient disposition targets, as well as extended hours of primary care, demonstrated promising outcomes. While the review identified increased presentations by the elderly with complex and chronic conditions as an emerging and widespread driver of crowding, more research is required to isolate the precise local factors leading to ED crowding, with system-wide solutions tailored to address identified causes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.