Evidence map›Paper›PMID 42032455›Full record

SynthesisBMC emergency medicine2026

Interventions to reduce emergency department overcrowding and their effects on patient outcomes: a mixed-methods systematic review and meta-analysis.

Weaam Alamri, Farah Aljuhani, Nouf Alsharef, Rebal Khayyat, Manal Shuaib, Tahira Faheem, Abdu Alsayed

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in BMC emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Weaam AlamriDepartment of Medicine and Surgery, Batterjee Medical College, Jeddah, 21442, Saudi Arabia. Weaam.ib.alamri@gmail.com.
Farah AljuhaniDepartment of Medicine and Surgery, Batterjee Medical College, Jeddah, 21442, Saudi Arabia.
Nouf AlsharefDepartment of Medicine and Surgery, Batterjee Medical College, Jeddah, 21442, Saudi Arabia.
Rebal KhayyatDepartment of Medicine and Surgery, Batterjee Medical College, Jeddah, 21442, Saudi Arabia.
Manal ShuaibDepartment of Medicine and Surgery, Batterjee Medical College, Jeddah, 21442, Saudi Arabia.
Tahira FaheemDepartment of Medicine and Surgery, Batterjee Medical College, Jeddah, 21442, Saudi Arabia.
Abdu AlsayedDepartment of Emergency Medicine, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOvercrowding in emergency departments (EDs) leads to inadequate patient outcomes and increased operational costs. These complications contribute to heightened stress on healthcare systems thus, effective methods to reduce ED overcrowding are necessary to improve patient flow and overall care quality.

aimThis mixed-method systematic review and meta-analysis evaluates the effectiveness of interventions such as Fast-Track, Team Triage, and Point-Of-Care Testing (POCT) in reducing ED overcrowding and improving patient flow metrics, including ED length of stay (LOS), wait times, and discharge times, to provide evidence-based recommendations for policy and practice in emergency healthcare.

methodsThis review complies with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three databases (PubMed, ScienceDirect and Google Scholar) were systematically searched for studies published between 2015 and 2025 assessing interventions to reduce ED overcrowding. A structured risk-of-bias assessment (RoB 2, ROBINS-I, JBI, MMAT) indicated overall acceptable methodological quality, with expected limitations related to non-randomized designs and limited blinding. Mean LOS was pooled using random-effects meta-analysis in RevMan, with heterogeneity assessed and secondary outcomes summarized narratively. This study is registered with the International Prospective Register of Systematic Reviews (PROSPERO 2025: CRD42025634351).

resultsThis review included 15 studies, 6 eligible for meta-analysis. Fast-Track significantly reduced ED length of stay (MD = − 20.89 min; 95% CI: − 37.05 to − 4.33; p = 0.01). POCT (MD = − 65.50 min; 95% CI: − 137.54 to 6.53; p = 0.07) and Team Triage (MD = − 46.11 min; 95% CI: − 120.59 to 28.38; p = 0.23) demonstrated variable reductions in ED LOS, with pooled effects influenced by substantial between-study heterogeneity. All analyses exhibited significant heterogeneity. Qualitative synthesis further suggested improvements in waiting times, patient throughput, and departmental efficiency.

conclusionOur findings highlight the importance of targeted interventions to alleviate ED overcrowding; Fast-Track showed consistent effectiveness, while POCT and Team Triage showed variable and, often context-dependent effects. These findings offer practical and evidence-based strategies to support ED flow improvements, though further high-quality research is needed.

Indexed as

CrowdingEmergency Service, HospitalEmergency Room VisitsHumansLength of StayPoint-of-Care TestingTriageEmergency Department (ED)Fast trackLength of stay (LOS)OvercrowdingPoint Of Care Testing (POCT)Team triage

Identifiers

PMID42032455
PMCPMC13255496

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.