CLINICAL PRACTICE
SAEM PULSE | NOVEMBER-DECEMBER 2023
The Escalating Crisis: Hospital Capacity and the Vital Role of the ED Medical Officer of the Day
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By Maulik Lathiya, MBBS; Susan Cullinan, MD; and Matthew Olmstead, DO As health care systems around the globe grapple with the modern challenges posed by pandemics, growing populations, and the natural progression of illnesses, the importance of health care infrastructure and capacity planning has never been more apparent. This significance is particularly evident in the United States, where issues related to hospital and emergency department (ED) capacity underscore the need for preparedness and adaptability. While large urban centers have long grappled with overcrowding and capacity constraints,
these challenges are now spilling over into smaller regional hubs and critical access community medical centers.
From Urban Centers to Regional Hubs: A Cascading Challenge
Historically, large urban health care facilities prepared for periodic surges in patient counts, utilizing their infrastructural resources, human capital, and experience to manage these occasional influxes, albeit imperfectly. Conversely, regional hubs and smaller community medical centers experienced
steadier patient flows. However, the evolving health care landscape has thrust these smaller settings into challenges previously limited to larger counterparts. Struggling with limited resources and bandwidth, they now face overwhelming demands beyond their traditional capacity.
Emergency Department Boarding: A Manifestation of the Crisis
One alarming manifestation of this crisis is ED boarding. When smaller centers experience a sudden surge in patient