SynthesisBMC emergency medicine2019
Effectiveness of interventions to alleviate emergency department crowding by older adults: a systematic review.
Synthesis in BMC emergency medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Patient flow in emergency departments: a comprehensive umbrella review of solutions and challenges across the health system.BMC health services research · 2024Pooled it
- Evaluating implementation of a geriatrician-led emergency department model of care: a qualitative study using the consolidated framework for implementation research.European geriatric medicine · 2026Article
- Streaming and redirection of lower acuity adult patients attending the ED: patient and staff experience.Emergency medicine journal : EMJ · 2025Article
- Experiences of the emergency department environment: a qualitative study with caregivers of people with dementia.Internal and emergency medicine · 2025Article
- "A banana in the tailpipe": a qualitative study of patient flow in the healthcare system.BMC health services research · 2025Article
- Older Adults' Experiences of Emergency Department Admission Decisions: A Qualitative Study in a Public Safety Net Hospital.Journal of general internal medicine · 2025Article
- Determinants of Severely Prolonged Emergency Department Stays Among Older Adults: A Retrospective Comparative Analysis.Journal of nursing management · 2025Article
- Observational
- Scoping review of the effectiveness of 10 high-impact initiatives (HIIs) for recovering urgent and emergency care services.BMJ open quality · 2024Article
- Abated crowding by fast-tracking the Throughput component of the ED for patients in no need of hospitalization with competency managed personnel.BMC emergency medicine · 2024Article
- Overcrowding in emergency departments: an overview of reviews describing global solutions and their outcomes.Internal and emergency medicine · 2024Review
- Strategies for improving ED-related outcomes of older adults who seek care in emergency departments: a systematic review.International journal of emergency medicine · 2024Review
- Epidemiology and Clinical Characteristics of Older Patients Transferred from Long-Term-Care Hospitals (LTCHs) to Emergency Departments by a Comparison with Non-LTCHs in South Korea: A Cross-Sectional Observational Study.International journal of environmental research and public health · 2022Observational
- Factors Associated with Emergency Department Visits and Consequent Hospitalization and Death in Korea Using a Population-Based National Health Database.Healthcare (Basel, Switzerland) · 2022Article
- Capturing the value of vaccination: impact of vaccine-preventable disease on hospitalization.Aging clinical and experimental research · 2022Article
- Usability Testing of a Patient-Centered Mobile Health App for Supporting and Guiding the Pediatric Emergency Department Patient Journey: Mixed Methods Study.JMIR pediatrics and parenting · 2022Article
- Portrait of the Emergency Department at Orotta National Referral and Teaching Hospital in Asmara, Eritrea: A Prospective Observational Study.Open access emergency medicine : OAEM · 2022Article
- Dutch emergency physicians insufficiently educated in geriatric emergency medicine: results of a nationwide survey.Age and ageing · 2021Article
- Exploring overcrowding trends in an inner city emergence department in the UK before and during COVID-19 epidemic.BMC emergency medicine · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe growing demand for elderly care often exceeds the ability of emergency department (ED) services to provide quality of care within reasonable time. The purpose of this systematic review is to assess the effectiveness of interventions on reducing ED crowding by older patients, and to identify core characteristics shared by successful interventions.
methodsSix major biomedical databases were searched for (quasi)experimental studies published between January 1990 and March 2017 and assessing the effect of interventions for older patients on ED crowding related outcomes. Two independent reviewers screened and selected studies, assessed risk of bias and extracted data into a standardized form. Data were synthesized around the study setting, design, quality, intervention content, type of outcome and observed effects.
resultsOf the 16 included studies, eight (50%) were randomized controlled trials (RCTs), two (13%) were non-RCTs and six (34%) were controlled before-after (CBA) studies. Thirteen studies (81%) evaluated effects on ED revisits and four studies (25%) evaluated effects on ED throughput time. Thirteen studies (81%) described multicomponent interventions. The rapid assessment and streaming of care for older adults based on time-efficiency goals by dedicated staff in a specific ED unit lead to a statistically significant decrease of ED length of stay (LOS). An ED-based consultant geriatrician showed significant time reduction between patient admission and geriatric review compared to an in-reaching geriatrician.
conclusionInter-study heterogeneity and poor methodological quality hinder drawing firm conclusions on the intervention's effectiveness in reducing ED crowding by older adults. More evidence-based research is needed using uniform and valid effect measures.
trial registrationThe protocol is registered with the PROSPERO International register of systematic reviews: ID = CRD42017075575).
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