overcrowding

A site dedicated to our patients, their care, and their safety

Note: If you have any materials to add to this site, questions, or comments, please contact me by e-mail: Peter Viccellio. Obviously, my focus is on content, not creating a visually fascinating web site. If you want pretty, then go to my wife's art site. She does commission work as well.

I am a practicing emergency physician and clinical director of the emergency department at Stony Brook on Long Island. Our institution believes that the ED is a vital community resource, and must be able to deliver needed services at all times. We do not consider ambulance diversion a responsible option. We also believe that admitted patients are best cared for by health care providers whose specialty is inpatient care, in a quiet and calm place where that care can be best provided. Thus, we use the "Full capacity protocol" (FCP) at Stony Brook, which moves patients upstairs when we're full, allowing us to address high hospital census in a distributive and safe fashion.

Note: Many of these efforts were due to the crucial support of the Emergency Medicine Foundation, the education and research arm of the American College of Emergency Physicians. The EMF is the only national organization organized for the specific purpose of funding research in emergency medicine. The EMF has funded crucial research in areas including patient safety, overcrowding, cardiac resuscitation, and neurological emergencies. For further information, or to support the EMF, please visit the EMF website.

Included here are some articles on overcrowding, our FCP, and some rulings by the DOH on this matter. The articles may be helpful in changing the culture which surrounds the issues related to hospital overcrowding. Use them as you see fit. You are welcome to contact me if you have questions about our initiative to assure our patients' safety and provide care in a humane fashion.

Overcrowding Powerpoint Presentation - contains information on length of stay, nurse-patient ratios, patient satisfaction scores, etc.

(NEW) Key Points Powerpoint Presentation - contains data related to the grave harm caused by overcrowding, and the impact of the full capacity protocol on waiting times.

Want to see real results? Read about this "before and after" implementation of the FCP:

(NEW) A "work in progress" white paper on the causes, consequences, and solutions to hospital crowding. This provides what I believe is an important literature-based review of safety issues, demonstrating the grave consequences of crowding and emergency care. There are two versions, the second one a more detailed analysis of the consequences:

Past history - a new addition, which contains some past articles and clips from the news media on hospital overcrowding dating back to 1987.

If your hospital is committed to patient safely, note particularly the information on nurse-staffing ratios near the end of the PPT presentation. Also show your CEO the data on length of stay.

Newest NY DOH memorandum on overcrowding - March, 2002

Hospital Overcrowding

A site dedicated to our patients, their care, and their safety