Emergency Department Overcrowding in Canada: Multistakeholder Dialogue

During 3 multistakeholder dialogue sessions, patients, families, community members, emergency department (ED) staff and trainees told us that ED overcrowding results from a wider health care system dysfunction. They communicated that a major driving force is hospitals operating at or over capacity and large proportions of alternate level of care patients unable to be discharged due to lack of long-term care spaces. We heard that an absence of health care resources available within communities could worsen the problem by filling the ED with patients who could be managed more appropriately elsewhere. Participants described how this creates frustration among patients and families and can contribute to staff burnout and moral distress. Participants suggested that to effect change, solutions need to address accountability and incorporate integration across the health care systems. We heard that the specific health needs of patients and families should drive decision-making about solutions. Participants described that currently available technologies and data are not being used to their full potential.