Directors of emergency medicine's beliefs about, barriers to, and enablers of solutions to emergency department crowding and access block

Abstract

Objective: To identify opportunities for directors of emergency medicine (DEMs) to lead change efforts to address ED crowding and access block.

Methods: DEMs were surveyed about their beliefs about, barriers to, and enablers of solutions to ED crowding and access block.

Results: Key barriers were insufficient resources, entrenched hospital culture, and lack of political will to address ED crowding and access block. Key enablers were developing hospital-wide understanding of the problems, developing a supportive hospital culture, and improved engagement by hospital executive.

Conclusion: Addressing the political and cultural forces that sustain ED crowding and access block are key adaptive challenges requiring DEM leadership.

Keywords: directors of emergency medicine; leadership; overcrowding and access block.