Crowded ED equals worse management of pain

Packed waiting rooms mean that patients suffer

When ED waiting rooms are overcrowded, patients with severe pain are more likely to get poor quality care, according to a recent study. Researchers found that only about half (49%) of 13,758 patients with severe pain received pain medication. Of those, 59% had more than an hour delay in treatment from triage, and 20% had more than an hour delay in treatment after being placed in a room.1

"It is vital for emergency nurses to understand the impact that a crowded ED has on quality of care," says Jesse M. Pines, MD, MBA, MSCE, the study's lead author and assistant professor of emergency medicine at the University of Pennsylvania School of Medicine in Philadelphia. "The first step is for nurses to recognize that this is an issue: that their patients suffer when the ED is crowded."

While this may come as no surprise to nurses who work in busy EDs, recognition that quality of care suffers when the ED is crowded is important to quality improvement, Pines emphasizes. "This is as much a message for ED staff as it is for government and quality organizations who should implement public policy to make hospitals fix ED crowding," he says.


1. Pines JM, Hollander JE. Emergency department crowding is associated with poor care for patients with severe pain. Ann Emerg Med 3 October 2007. DOI: 10.1016/j.annemergmed.2007.07.008.


For more information about pain management and overcrowding, contact:

  • Jesse M. Pines, MD, MBA, MSCE, Assistant Professor of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia. Phone: (215) 662-4050. E-mail: