"The Royal College of Emergency Medicine (RCEM) is calling for action to address the significant challenges that confront Accident and Emergency (A&E) departments and, whilst some progress has been made, there is still much work to be done to provide a safe and efficient service for patients throughout the UK."
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Crowding is the most important problem facing Emergency Departments worldwide. In the UK crowding in EDs is worsening. The visible effects are ambulances queuing outside emergency departments, trolleys on corridors within EDs, and long waits in EDs both to be seen and to be transferred out to a ward. The invisible effects are the harm caused to both patients and staff.
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"A condition called ‘exit block’ is harming patients: they are put at risk when ‘exit block’ occurs. This happens where you cannot transfer patients from Emergency Departments into a hospital inpatient bed. Exit block is explained in more detail in this video: Exit Block: What it is and why it is dangerous.
Over 500,000 patients a year are affected by exit block. The College of Emergency Medicine says that this is unacceptable.
We are concerned about patient safety. When the A&E becomes crowded because of Exit Block we know that patients do less well. We know that crowding kills. It is simply not acceptable to let this situation continue which is why we are on a mission to urge hospital Chief Executives and their Boards to make sure they have plans to deal with this issue."
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"I welcome the publication of this toolkit and strongly advise all those involved in emergency care to read it. This document represents an enormous amount of careful thought, lively debate and hard work by members of the Service Design and Delivery Committee, and previously the authors of the first crowding guideline, which this replaces. Exit block and the consequential emergency department crowding is the single most important issue affecting our patients and staff today. This document explains why emergency department crowding is of such significance and makes several important and achievable recommendations. It cannot be emphasised enough that resolving emergency department crowding is the collective responsibility of the entire health care system. Emergency Department crowding is not inevitable and this toolkit shows how to reduce the associated harm."