ArticleInternational journal of emergency medicine2025
Emergency department crowding in the Netherlands; evaluation of a real-time ambulance diversion dashboard.
Article in International journal of emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Emergency department crowding in the modern era: a systematic review (2018-2025).Clinical and experimental emergency medicine · 2026Pooled it
- Crowding in real-time: an artificial intelligence-based model to manage crowding in the emergency department (CRAMMED Study).BMC emergency medicine · 2026Article
- EmergInsight: a real-time dashboard for optimizing emergency care through data visualization and analytics.JAMIA open · 2026Article
- Performance Indicators in Emergency Medical Services: A Scoping Review of Dashboard Applications in the Context of Crisis Management.Archives of academic emergency medicine · 2026Review
- Waiting time ambulances in the Emergency Department; a Dutch single center study (WAITED study).International journal of emergency medicine · 2025Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergency department (ED) crowding is a growing concern worldwide and associated with negative effects. In 2013, 68% of Dutch ED-managers experienced crowding on several days of the week. This resulted into the introduction in phases of an ambulance diversion dashboard, in order to influence ED input. Increasing numbers of Dutch EDs have implemented this dashboard, visualizing regional ambulance diversions by means of a traffic light.
methodsThis is a descriptive study of a nationwide online survey of Dutch EDs, conducted between January and October 2023. It included both qualitative and quantitative questions. The outcomes and analysis are derived from descriptive data of respondents' experience of crowding as well as their usage and perceived effectiveness of the ambulance diversions dashboard.
resultsAt the time of the survey, 62 of 82 Dutch EDs (75.6%) actually used the dashboard, of which 56 EDs responded (90.3% response rate). 69.7% Of ED managers experienced ED crowding more than three times a week. Of the respondents using the dashboard, 52.8% reported it only occasionally alleviates ED inflow. The purported reasons are the limited number of patients affected by the red light (ambulance diversion) and the presence of regional crowding. The effects of the orange light (impending ambulance diversion) on ED input differ greatly among hospitals, mostly due to their own internal agreements. In accordance, many respondents (53.6%) expressed dissatisfaction with the resources available to them to alleviate crowding.
conclusionAfter conducting a national survey, ED crowding is reported as a persisting nationwide problem with its prevalence largely unchanged since the introduction of the ambulance diversion dashboard. Most hospitals reported having insufficient resources to alleviate it. The effects of the ambulance diversion dashboard to decrease crowding are apparently limited because it affects a small portion of total ED presentations and because of the influence of regional crowding. The main function of the orange light is to increase ED throughput and output rather than reducing ED input.
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