ENA offers ideas about overcrowding to JCAHO

The Joint Commission on Accreditation of Healthcare Organizations recently announced its intention to create a new standard addressing ED crowding for the 2004 Hospital Accreditation Manual, and the Emergency Nurses Association (ENA) in Des Plaines, IL, responded immediately with suggestions for how the accrediting body might address the problem.

Writing for the ENA, president Kathy Robinson, RN, says the group is concerned that the proposed standards "are not substantive enough and fall short of imposing meaningful requirements on hospitals t o address the critical issue of emergency department overcrowding." The standard fails to address some key causes of overcrowding, Robinson says.

The ENA urges the Joint Commission to address other factors such as the increasing age and medical complexity of the patient population, hospital capacity and patient flow patterns, surge capacity for unexpected influx of acute patients, and what Robinson calls "the inherent conflict between the ability of inpatient units to close beds to patients and the emergency departments’ federal mandate to screen and stabilize patients regardless of capacity."

The ENA also urged the Joint Commission to remove from the proposed standard a passage that addresses holding patients for observation in the ED, saying it seems to condone the practice of boarding patients in the ED. Instead, ENA recommends developing direct admission policies that divert incoming patients from other facilities to an inpatient bed, rather than to the ED to await availability.


For more information, contact:

Emergency Nurses Association, 915 Lee St., Des Plaines, IL 60016-6569. Telephone: (800) 900-9659.