Interventions to reduce overcrowding in emergency departments: An umbrella review

IF 2.2 4区医学 Q2 NURSING

International Emergency Nursing Pub Date : 2026-02-01 Epub Date: 2025-12-05 DOI:10.1016/j.ienj.2025.101729

Eduardo Santos , Ana Carolina Brito , Luana Fonseca , Margarida Figueiredo , Matilde Esteves , Diana Santos

{"title":"Interventions to reduce overcrowding in emergency departments: An umbrella review","authors":"Eduardo Santos , Ana Carolina Brito , Luana Fonseca , Margarida Figueiredo , Matilde Esteves , Diana Santos","doi":"10.1016/j.ienj.2025.101729","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To identify and evaluate the effectiveness of interventions and/or strategies to reduce overcrowding in Emergency Departments (EDs).</div></div><div><h3>Method</h3><div>An umbrella review was performed using the JBI method. Eight search resources were considered. Two independent reviewers carried out the selection of studies, quality assessment, data extraction, and synthesis.</div></div><div><h3>Results</h3><div>Twenty systematic reviews were included, which identified several interventions to reduce overcrowding in EDs, such as: joint triage (physicians and nurses); creation of fast tracks; introduction of Rapid Assessment Units; request for auxiliary diagnostic tests by nurses; streaming; collaboration with Primary Health Care (PHC) for referral of non-urgent cases; allocation of PHC units within or adjacent to EDs; triage by PHC professionals; extension of PHC hours; increase in hospital capacity; creation of full capacity protocols; hiring of specialist professionals; lean thinking; reverse triage. The most effective interventions and/or strategies were: joint triage; creation of fast-track routes; introduction of rapid assessment units; request for auxiliary diagnostic tests by nurses; streaming; and collaboration with PHC for referral of non-urgent cases.</div></div><div><h3>Conclusion</h3><div>The combination of effective triage, appropriate flow management, and proactive action by the team appears to be key to mitigating overcrowding in the EDs. Joint triage and fast-track routes are the most effective measures. The expanded role of nurses − including their ability to request examinations and manage rapid assessment units − is also crucial to speeding up care.</div></div>","PeriodicalId":48914,"journal":{"name":"International Emergency Nursing","volume":"84 ","pages":"Article 101729"},"PeriodicalIF":2.2000,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Emergency Nursing","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1755599X25001600","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/12/5 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

To identify and evaluate the effectiveness of interventions and/or strategies to reduce overcrowding in Emergency Departments (EDs).

Method

An umbrella review was performed using the JBI method. Eight search resources were considered. Two independent reviewers carried out the selection of studies, quality assessment, data extraction, and synthesis.

Results

Twenty systematic reviews were included, which identified several interventions to reduce overcrowding in EDs, such as: joint triage (physicians and nurses); creation of fast tracks; introduction of Rapid Assessment Units; request for auxiliary diagnostic tests by nurses; streaming; collaboration with Primary Health Care (PHC) for referral of non-urgent cases; allocation of PHC units within or adjacent to EDs; triage by PHC professionals; extension of PHC hours; increase in hospital capacity; creation of full capacity protocols; hiring of specialist professionals; lean thinking; reverse triage. The most effective interventions and/or strategies were: joint triage; creation of fast-track routes; introduction of rapid assessment units; request for auxiliary diagnostic tests by nurses; streaming; and collaboration with PHC for referral of non-urgent cases.

Conclusion

The combination of effective triage, appropriate flow management, and proactive action by the team appears to be key to mitigating overcrowding in the EDs. Joint triage and fast-track routes are the most effective measures. The expanded role of nurses − including their ability to request examinations and manage rapid assessment units − is also crucial to speeding up care.

查看原文本刊更多论文

减少急诊科过度拥挤的干预措施：概括性审查

目的确定和评估减少急诊科过度拥挤的干预措施和/或策略的有效性。方法采用JBI方法进行综述。考虑了8种搜索资源。两名独立审稿人进行了研究选择、质量评估、数据提取和综合。结果纳入了20项系统评价，确定了几种缓解急诊科人满为患的干预措施，如：联合分诊（医生和护士）；建立快速通道；引入快速评估小组；要求护士进行辅助诊断测试；流媒体;与初级保健机构合作，转诊非紧急病例；在急诊科内或邻近地区分配初级保健单位；由初级保健专业人员分诊；延长初级保健时间；增加医院容量；制定满负荷协议；聘用专业人员；精益思想;反向分流。最有效的干预措施和/或策略是：联合分诊；建立快速通道；引进快速评估单位；要求护士进行辅助诊断测试；流媒体;并与初级保健中心合作转诊非紧急病例。结论有效的分诊、适当的流量管理和团队的积极行动相结合是缓解急诊科过度拥挤的关键。联合分流和快速通道是最有效的措施。扩大护士的作用——包括她们要求检查和管理快速评估单元的能力——对加快护理速度也至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Emergency Nursing NURSING-

CiteScore

3.20

自引率

11.10%

发文量

期刊介绍： International Emergency Nursing is a peer-reviewed journal devoted to nurses and other professionals involved in emergency care. It aims to promote excellence through dissemination of high quality research findings, specialist knowledge and discussion of professional issues that reflect the diversity of this field. With an international readership and authorship, it provides a platform for practitioners worldwide to communicate and enhance the evidence-base of emergency care. The journal publishes a broad range of papers, from personal reflection to primary research findings, created by first-time through to reputable authors from a number of disciplines. It brings together research from practice, education, theory, and operational management, relevant to all levels of staff working in emergency care settings worldwide.