‘Access block’ is the delay between when people are admitted and when they have access to an inpatient bed. It is often associated with emergency department overcrowding. Reviewers from Hong Kong examined strategies to reduce access block and emergency department overcrowding. Seven bibliographic databases were searched for articles or editorials containing empirical data. Strategies addressing emergency department overcrowding included co-locating primary care within the emergency department, fast-track and emergency nurse practitioners. Strategies targeting access block included holding units, early discharge, action-management and resource priority. There was no evidence that one strategy was more effective than another.
Reference: Chan SS, Cheung NK, Graham CA, Rainer TH. Strategies and solutions to alleviate access block and overcrowding in emergency departments. Hong Kong Medical Journal. 2015. Jun 19 [Epub ahead of print]