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GAO-09-348SP: 

United States Government Accountability Office: 
Washington, DC 20548: 

Hospital Emergency Departments: Bibliography (GAO-09-348SP, April 30, 
2009), an E-supplement to GAO-09-347: 

Read the Full Report: Hospital Emergency Departments: Crowding 
Continues to Occur, and Some Patients Wait Longer than Recommended Time 
Frames (GAO-09-347, April 30, 2009). 

This document presents a bibliography of a literature review conducted 
as part of our work on emergency department crowding (GAO-09-347). As 
part of our work to analyze and report on information made available 
since 2003 about (1) three indicators of emergency department crowding-
-ambulance diversion, wait times, and patient boarding,[Footnote 1] and 
(2) factors that contribute to emergency department crowding, we 
conducted a literature review of 197 articles, including articles 
published in peer-reviewed and other periodicals, publications from 
professional, research, and other organizations, and reports issued by 
federal and state agencies. In examining the information made available 
since 2003 about indicators of crowding during our literature review, 
we also analyzed articles for what was reported on the effect of 
crowding on patient quality of care and proposed strategies to address 
crowding. In order to obtain these articles, we conducted structured 
searches of 16 research databases and obtained articles identified as a 
result of interviews with federal officials, professional and research 
organizations, and subject-matter experts, and through searches of 
related Web sites.[Footnote 2] 

We reviewed 197 articles, publications, and reports (which we call 
articles) on emergency department crowding published on or between 
January 1, 2003, and August 31, 2008. This e-supplement lists each 
article we reviewed for this engagement and is arranged in four 
separate sections based on the type of article: (1) articles reporting 
results of quantitative analysis, (2) commentaries, (3) articles 
reporting on literature reviews, or (4) other articles, which include 
articles published on or between January 1, 2003, and August 31, 2008, 
that were identified as a result of our interviews with federal 
officials, professional and research organizations, and subject-matter 
experts. This fourth category, "other articles," includes articles that 
are published by professional associations to report results of their 
surveys. Additional information about the methodology used in the 
literature review is contained in our report, Hospital Emergency 
Departments: Crowding Continues to Occur, and Some Patients Wait Longer 
than Recommended Time Frames (GAO-09-347). 

Each section of articles is alphabetized by the author's last name or 
by the title of the article if there is no author. 

We conducted this performance audit from May 2008 through April 2009 in 
accordance with generally accepted government auditing standards. Those 
standards require that we plan and perform the audit to obtain 
sufficient, appropriate evidence to provide a reasonable basis for our 
findings and conclusions based on our audit objectives. We believe that 
the evidence obtained provides a reasonable basis for our findings and 
conclusions based on our audit objectives. 

If you have questions concerning this bibliography, please contact 
Marcia Crosse at (202) 512-7114 or crossem@gao.gov. 

Contents: 

Articles Reporting Results of Quantitative Analysis (80 articles): 

Commentaries (64 articles): 

Articles Reporting on Literature Reviews (8 articles): 

Other Articles (45 articles): 

[End of section] 

Articles Reporting on Quantitative Analysis (80 articles): 

Asamoah, O. K., S. J. Weiss, A. A. Ernst, M. Richards, and D. P. 
Skylar. "A Novel Diversion Protocol Dramatically Reduces Diversion 
Hours." American Journal of Emergency Medicine, vol. 26, no. 6 (2008): 
670-75. 

Asaro, P. V., L. M. Lewis, and S. B. Boxerman. "Emergency Department 
Overcrowding: Analysis of the Factors of Renege Rate." Academic 
Emergency Medicine, vol. 14, no. 2 (2007): 157-62. 

Asaro, P. V., L. M. Lewis, and S. B. Boxerman. "The Impact of Input and 
Output Factors on Emergency Department Throughput." Academic Emergency 
Medicine, vol. 14, no. 3 (2007): 235-42. 

Ballard, D. W., R. W. Derlet, B. A. Rich, and R. A. Lowe. "EMTALA, Two 
Decades Later: A Descriptive Review of Fiscal Year 2000 Violations." 
American Journal of Emergency Medicine, vol. 24, no. 2 (2006): 197-205. 

Baumann, M. R., and T.D. Strout. "Evaluation of the Emergency Severity 
Index (Version 3) Triage Algorithm in Pediatric Patients." Academic 
Emergency Medicine, vol. 12, no. 3 (2005): 219-24. 

Bayley, M. D., J. S. Schwartz, F. S. Shofer, M. Weiner, F. D. Sites, K. 
B. Traber, and J. E. Hollander. "The Financial Burden of Emergency 
Department Congestion and Hospital Crowding for Chest Pain Patients 
Awaiting Admission." Annals of Emergency Medicine, vol. 45, no. 2 
(2005): 110-17. 

Begley, C. E., Y. Chang, R. C. Wood, and A. Weltge. "Emergency 
Department Diversion and Trauma Mortality: Evidence from Houston, 
Texas." Journal of Trauma, Injury, Infection, and Critical Care, vol. 
57, no. 6 (2004): 1260-65. 

Bernstein, S. L., V. Verghese, W. Leung, A. T. Lunney, and I. Perez. 
"Development and Validation of a New Index to Measure Emergency 
Department Crowding." Academic Emergency Medicine, vol. 10, no. 9 
(2003): 938-42. 

Boudreaux, E. D., C. V. Mandry, and K. Wood. "Patient Satisfaction Data 
as a Quality Indicator: A Tale of Two Emergency Departments." Academic 
Emergency Medicine, vol. 10, no. 3 (2003): 261-68. 

Bourgeois, F. T., and M. W. Shannon. "Emergency Care for Children in 
Pediatric and General Emergency Departments." Pediatric Emergency Care, 
vol. 23, no. 2 (2007): 94-102. 

Brosseau, D. C., J. Bergholte, and M. H. Gorelick. "The Effect of Prior 
Interactions With a Primary Care Provider on Nonurgent Pediatric 
Emergency Department Use." Archives of Pediatric & Adolescent Medicine, 
vol. 158, no. 1 (2004): 78-82. 

Burt, C. W., L. F. McCaig, and R. H. Valverde. "Analysis of Ambulance 
Transports and Diversions Among US Emergency Departments." Annals of 
Emergency Medicine, vol. 47, no. 4 (2006): 317-26. 

Chalfin, D. B., S. Trzeciak, A. Likourezos, B. M. Baumann, and R. P. 
Dellinger. "Impact of Delayed Transfer of Critically Ill Patients From 
the Emergency Department to the Intensive Care Unit." Critical Care 
Medicine, vol. 35, no. 6 (2007): 1477-83. 

Chan, T. C., J. P. Killeen, D. Kelly, and D. A. Guss. "Impact of Rapid 
Entry and Accelerated Care at Triage on Reducing Emergency Department 
Patient Wait Times, Lengths of Stay, and Rate of Left Without Being 
Seen." Annals of Emergency Medicine, vol. 46, no. 6 (2005): 491-97. 

Chen, E. H., A. M. Mills, B. Y. Lee, J. L. Robey, K. E. Zogby, F. S. 
Shofer, P. M. Reilly, and J. E. Hollander. "The Impact of a Concurrent 
Trauma Alert Evaluation on Time to Head Computed Tomography in Patients 
with Suspected Stroke." Academic Emergency Medicine, vol. 13, no. 3 
(2006): 349-52. 

Chia, W. T., Y. S. Chen, C. F. Lin, H. H. Lie, and B. F. Lin. 
"Difference in Time to X Ray with Similar Time to Treatment Decision 
Leads to Differences in Waiting Times of Patients with Hip Fracture in 
a Crowded Emergency Department." Emergency Medicine Journal, vol. 25, 
no. 5 (2008): 274-275. 

Ding, R., J. J. Jung, T. D. Kirsch, F. Levy, and M. L. McCarthy. 
"Uncompleted Emergency Department Care: Patients Who Leave Against 
Medical Advice." Academic Emergency Medicine, vol. 14, no. 10 (2007): 
870-76. 

Epps, C. D., L. J. Ware, and A. Packard. "Ethnic Wait Time Differences 
in Analgesic Administration in the Emergency Department." Pain 
Management Nursing, vol. 9, no. 1 (2008): 26-32. 

Epstein, S. K., and L. Tian. "Development of an Emergency Department 
Work Score to Predict Ambulance Diversion." Academic Emergency 
Medicine, vol. 13, no. 4 (2006): 421-26. 

Falvo, T., L. Grove, R. Stachura, and W. Zirkin. "The Financial Impact 
of Ambulance Diversion and Patient Elopements." Academic Emergency 
Medicine, vol. 14, no. 1 (2007): 58-62. 

Falvo, T., L. Grove, R. Stachura, D. Vega, R. Stike, M. Schlenker, and 
W. Zirkin. "The Opportunity Loss of Boarding Admitted Patients in the 
Emergency Department." Academic Emergency Medicine, vol. 14, no. 4 
(2007): 332-37. 

Fee, C., E. J. Weber, C. A. Maak, and P. Bacchetti. "Effect of 
Emergency Department Crowding on Time to Antibiotics in Patients 
Admitted with Community-Acquired Pneumonia." Annals of Emergency 
Medicine, vol. 50, no. 5 (2007): 501-09. 

Flottemesch, T. J., B. D. Gordon, and S. S. Jones. "Advanced 
Statistics: Developing a Formal Model of Emergency Department Census 
and Defining Operational Efficiency." Academic Emergency Medicine, vol. 
14, no. 9 (2007): 799-809. 

Garson, C., J. E. Hollander, K. V. Rhodes, F. S. Shofer, W. G. Baxt, 
and J. M. Pines. "Emergency Department Patient Preferences for Boarding 
Locations When Hospitals Are at Full Capacity." Annals of Emergency 
Medicine, vol. 51, no. 1 (2008): 9-12. 

Green, L. V., J. Soares, J. F. Giglio, and R. A. Green. "Using Queueing 
Theory to Increase the Effectiveness of Emergency Department Provider 
Staffing." Academic Emergency Medicine, vol. 13, no. 1 (2006): 61-68. 

Han, J. H., C. Zhou, D. J. France, S. Zhong, I. Jones, A. B. Storrow, 
and D. Aronsky. "The Effect of Emergency Department Expansion on 
Emergency Department Crowding." Academic Emergency Medicine, vol. 14, 
no. 4 (2007): 338-43. 

Hoot, N. R., L. J. LeBlanc, I. Jones, S. R. Levin, C. Zhou, C. S. Gadd, 
and D. Aronsky. "Forecasting Emergency Department Crowding: A Discreet 
Event Simulation." Annals of Emergency Medicine, vol. 52, no. 2 (2008): 
116-25. 

Hoot, N. R., C. Zhou, I. Jones, and D. Aronsky. "Measuring and 
Forecasting Emergency Department Crowding in Real Time." Annals of 
Emergency Medicine, vol. 49, no. 6 (2007): 747-55. 

Howard, M. S., B. A. Davis, C. Anderson, D. Cherry, P. Koller, and D. 
Shelton. "Patients' Perspective for Choosing the Emergency Department 
for Nonurgent Medical Care: A Qualitative Study Exploring One Reason 
for Overcrowding." Journal of Emergency Nursing, vol. 31, no. 5 (2005): 
429-35. 

Hwang, U., L. D. Richardson, T. O. Sonuyi, and R. S. Morrison. "The 
Effect of Emergency Department Crowding on the Management of Pain in 
Older Adults With Hip Fracture." Journal of American Geriatric Society, 
vol. 54, no. 2 (2006): 270-75. 

Jones, S. S., T. L. Allen, T. J. Flottemesch, and S. J. Welch. "An 
Independent Evaluation of Four Quantitative Emergency Department 
Crowding Scales." Academic Emergency Medicine, vol. 13, no. 11 (2006): 
1204-11. 

Kennedy, J., K. Rhodes, C. A. Walls, B. R. Asplin. "Access to Emergency 
Care: Restricted by Long Waiting Times and Cost and Coverage Concerns." 
Annals of Emergency Medicine, vol. 43, no. 5 (2004): 567-73. 

Khaleghi, M., A. Loh, D. Vroman, T. C. Chan, and G. M. Vilke. "The 
Effects of Minimizing Ambulance Diversion Hours on Emergency 
Departments." Journal of Emergency Medicine, vol. 33, no. 2 (2007): 155-
59. 

Koran, Z. "The Impact of an Admission Unit on Failure-and Late-to- 
Rescue Rates in the Emergency Department." Advanced Emergency Nursing 
Journal, vol. 29, no. 4 (2007): 339-45. 

Lagoe, R. J., J. C. Kohlbrenner, L. D. Hall, M. Roizen, P. A. Nadle, 
and R. C. Hunt. "Reducing Ambulance Diversion: A Multihospital 
Approach." Prehospital Emergency Care, vol. 7, no. 1 (2003): 99-108. 

Lambe, S., D. L. Washington, A. Fink, M. Laouri, H. Liu, J. S. Fosse, 
R. H. Brook, and S. M. Asch. "Waiting Times in California's Emergency 
Departments." Annals of Emergency Medicine, vol. 41, no. 1 (2003): 35- 
44. 

Lee, K., and L. Davenport. "Can Case Management Interventions Reduce 
the Number of Emergency Department Visits by Frequent Users?" The 
Health Care Manager, vol. 25, no. 2 (2006): 155-59. 

Lee-Lewandrowski, E., D. Corboy, K. Lewandrowski, J. Sinclair, S. 
McDermot, and T. I. Benzer. "Implementation of a Point-of-Care 
Satellite Laboratory in the Emergency Department of an Academic Medical 
Center: Impact on Test Turnaround Time and Patient Emergency Department 
Length of Stay." Archives of Pathology & Laboratory Medicine, vol. 127, 
no. 4 (2003): 456-60. 

Liu, S., C. Hobgood, and J. H. Brice. "Impact of Critical Bed Status on 
Emergency Department Patient Flow and Overcrowding." Academic Emergency 
Medicine, vol. 10, no. 4 (2003): 382-85. 

McCarthy, M. L., D. Aronsky, I. D. Jones, J. R. Miner, R. A. Band, J. 
M. Baren, J. S. Desmond, K. M. Baumlin, R. Ding, and R. Shesser. "The 
Emergency Department Occupancy Rate: A Simple Measure of Emergency 
Department Crowding?" Annals of Emergency Medicine, vol. 51, no. 1 
(2008): 15-24. 

McCarthy, M. L., A. D. Shore, G. Li, J. New, J. J. Scheulen, N. Tang, 
R. Collela, and G. D. Kelen. "Likelihood of Reroute During Ambulance 
Diversion Periods in Central Maryland." Prehospital Emergency Care, 
vol. 11, no. 4 (2007): 408-15. 

McConnell, K. J., C. F. Richards, M. Daya, S. L. Bernell, C. C. 
Weathers, R. A. Lowe. "Effect of Increased ICU Capacity on Emergency 
Department Length of Stay and Ambulance Diversion." Annals of Emergency 
Medicine, vol. 45, no. 5 (2005): 471-78. 

McConnell, K. J., C. F. Richards, M. Daya, C. C. Weathers, and R. A. 
Lowe. "Ambulance Diversion and Lost Hospital Revenues." Annals of 
Emergency Medicine, vol. 48, no. 6 (2006): 702-10. 

McMullan J. T., and F. H. Veser. "Emergency Department Volume and 
Acuity as Factors in Patients Leaving Without Treatment." Southern 
Medical Journal, vol. 97, no. 8 (2004): 729-33. 

Meisel, Z. F., C. V. Pollack, C. C. Mechem, and J. M. Pines. 
"Derivation and Internal Validation of a Rule to Predict Hospital 
Admission in Prehospital Patients." Prehospital Emergency Care, vol. 
12, no. 3 (2008): 314-19. 

Mohanty, S. A., D. L. Washington, S. Lambe, A. Fink, and S. M. Asch. 
"Predictors of On-call Specialist Response in California Emergency 
Departments." Academic Emergency Medicine, vol. 13, no. 5 (2006): 505- 
12. 

Patel, P. B., R. W. Derlet, D. R. Vinson, M. Williams, and J. Wills. 
"Ambulance Diversion Reduction: the Sacramento Solution." American 
Journal of Emergency Medicine, vol. 24, no. 2 (2006): 206-13. 

Patel, P. B., and D. R. Vinson. "Team Assignment System: Expediting 
Emergency Department Care." Annals of Emergency Medicine, vol. 46, no. 
6 (2005): 499-506. 

Pines, J. M., C. Garson, W. G. Baxt, K. V. Rhodes, F. S. Shofer, and J. 
E. Hollander. "ED Crowding is Associated with Variable Perceptions of 
Care Compromise." Academic Emergency Medicine, vol. 14, no. 12 (2007): 
1176-81. 

Pines, J. M., and J. E. Hollander. "Emergency Department Crowding is 
Associated With Poor Care for Patients With Severe Pain." Annals of 
Emergency Medicine, vol. 51, no. 1 (2008): 1-5. 

Pines, J. M., J. E. Hollander, A. R. Localio, and J. P. Metlay. "The 
Association Between Emergency Department Crowding and Hospital 
Performance on Antibiotic Timing for Pneumonia and Percutaneous 
Intervention for Myocardial Infarction." Academic Emergency Medicine, 
vol. 13, no. 8 (2006): 873-78. 

Pines, J. M., A. R. Localio, J. E. Hollander, W. G. Baxt, H. Lee, C. 
Phillipps, and J. P. Metlay. "The Impact of Emergency Department 
Crowding Measures on Time to Antibiotics for Patients with Community- 
Acquired Pneumonia." Annals of Emergency Medicine, vol. 50, no. 5 
(2007): 510-16. 

Polevoi, S. K., J. V. Quinn, and N. R. Kramer. "Factors Associated With 
Patients Who Leave Without Being Seen." Academic Emergency Medicine, 
vol. 12, no. 3 (2005): 232-36. 

Quinn, J. V., S. V. Mahadevan, G. Eggers, H. Ouyang, and R. Norris. 
"Effects of Implementing a Rapid Admission Policy in the ED." American 
Journal of Emergency Medicine, vol. 25, no. 5 (2007): 559-63. 

Rathlev, N. K., J. Chessare, J. Olshaker, D. Obendorfer, S. D. Mehta, 
T. Rothenhaus, S. Crespo, et al. "Time Series Analysis of Variables 
Associated with Daily Mean Emergency Department Length of Stay." Annals 
of Emergency Medicine, vol. 49, no. 3 (2007): 265-71. 

Reeder, T. J., D. L. Burleson, and H. G. Garrison. "The Overcrowded 
Emergency Department: A Comparison of Staff Perceptions." Academic 
Emergency Medicine, vol. 10, no. 10 (2003): 1059-64. 

Richards, M. E., M. W. Hubble, and C. Crandall. "Influence of Ambulance 
Arrival on Emergency Department Time to Be Seen." Prehospital Emergency 
Care, vol. 10, no. 4 (2006): 440-46. 

Roberts, D. C., M. P. McKay, and A. Shaffer. "Increasing Rates of 
Emergency Department Visits for Elderly Patients in the United States, 
1993 to 2003." Annals of Emergency Medicine, vol. 51, no. 6 (2008): 169-
74. 

Rudkin, S. E., J. Oman, M. I. Langdorf, M. Hill, J. Bauche, P. Kivela, 
and L. Johnson. "The State of ED On-Call Coverage in California." 
American Journal of Emergency Medicine, vol. 22, no. 7 (2004): 575-81. 

Ruger, J. P., C. J. Richter, and L. M. Lewis. "Clinical and Economic 
Factors Associated with Ambulance Use to the Emergency Department." 
Academic Emergency Medicine, vol. 13, no. 8 (2006): 879-85. 

Ruger, J. P., C. J. Richter, E. L. Spitznagel, and L. M. Lewis. 
"Analysis of Costs, Length of Stay, and Utilization of Emergency 
Department Services by Frequent Users: Implications for Health Policy." 
Academic Emergency Medicine, vol. 11, no. 12 (2004): 1311-17. 

Sanchez, M., A. J. Smally, R. J. Grant, and L. M. Jacobs. "Effects of a 
Fast-track Area on Emergency Department Performance." The Journal of 
Emergency Medicine, vol. 31, no. 1 (2006): 117-20. 

Sedlak, S. K., and A. Roberts. "Implementation of Best Practices to 
Reduce Overall Emergency Department Length of Stay." Topics in 
Emergency Medicine, vol. 26, no. 4 (2004): 312-21. 

Shah, M. N., R. J. Fairbanks, C. L. Maddow, E. B. Lerner, J. I. Syrett, 
E. A. Davis, and S. M. Schneider. "Description and Evaluation of a 
Pilot Physician-directed Emergency Medical Services Diversion Control 
Program." Academic Emergency Medicine, vol. 13, no. 1 (2006) 54-60. 

Solberg, L. I., B. R. Asplin, R. M. Weinick, and D. J. Magid. 
"Emergency Department Crowding: Consensus Development of Potential 
Measures." Annals of Emergency Medicine, vol. 42, no. 6 (2003): 824-34. 

Steele, R., and A. Kiss. "EMDOC (Emergency Department Overcrowding) 
Internet-based Safety Net Research." Journal of Emergency Medicine, 
vol. 35, no. 1 (2008): 101-07. 

Sun, B. C., E. S. Binstadt, A. Pelletier, and C. A. Camargo, Jr. 
"Characteristics and Temporal Trends of 'Left Before Being Seen' Visits 
in U.S. Emergency Departments, 1995-2002." Journal of Emergency 
Medicine, vol. 32, no. 2 (2007): 211-215. 

Sun, B. C., S. A. Mohanty, R. Weiss, R. Tadeo, M. Hasbrouck, W. Koenig, 
C. Meyer, and S. Asch. "Effects of Hospital Closures and Hospital 
Characteristics on Emergency Department Ambulance Diversion, Los 
Angeles County, 1998 to 2004." Annals of Emergency Medicine, vol. 47, 
no. 4 (2006): 309-16. 

Takakuwa, K. M., F. S. Shofer, and S. B. Abbuhl. "Strategies for 
Dealing With Emergency Department Overcrowding: A One-year Study on How 
Bedside Registration Affects Patient Throughput Times." The Journal of 
Emergency Medicine, vol. 32, no. 4 (2007): 337-42. 

Vieth, T. L., and K. V. Rhodes. "The Effect of Crowding on Access and 
Quality in an Academic ED." American Journal of Emergency Medicine, 
vol. 24, no. 7 (2006): 787-94. 

Vilke, G. M., L. Brown, P. Skogland, C. Simmons, and D. A. Guss. 
"Approach to Decreasing Emergency Department Ambulance Diversion 
Hours." Journal of Emergency Medicine, vol. 26, no. 2 (2004): 189-92. 

Vilke, G. M., E. M. Castillo, M. A. Metz, L. U. Ray, P. A. Murrin, R. 
Lev, and T. C. Chan. "Community Trial to Decrease Ambulance Diversion 
Hours: The San Diego County Patient Destination Trial." Annals of 
Emergency Medicine, vol. 44, no. 4 (2004): 295-303. 

Walsh, P., V. Cortez, and H. Bhakta. "Patients Would Prefer Ward to 
Emergency Department Boarding While Awaiting an Inpatient Bed." Journal 
of Emergency Medicine, vol. 34, no. 2 (2008): 221-25. 

Wang, C., M. E. Villar, D. A. Mulligan, and T. Hansen. "Cost and 
Utilization Analysis of a Pediatric Emergency Department Diversion 
Project." Pediatrics, vol. 116, no. 5 (2005): 1075-79. 

Weiss, S. J., et al. "Comparison of the National Emergency Department 
Overcrowding Scale and the Emergency Department Work Index for 
Quantifying Emergency Department Crowding." Academic Emergency 
Medicine, vol. 13, no. 5 (2006): 513-18. 

Weiss, S. J., R. Derlet, J. Arndahl, A. A. Ernst, J. Richards, M. 
Fernández-Frankelton, R. Schwab, et al. "Estimating the Degree of 
Emergency Department Overcrowding in Academic Medical Centers: Results 
of the National ED Overcrowding Study (NEDOCS)." Academic Emergency 
Medicine, vol. 11, no. 1 (2004): 38-50. 

Weiss, S. J., A. A. Ernst, R. Derlet, R. King, A. Bair, and T. G. Nick. 
"Relationship Between the National ED Overcrowding Scale and the Number 
of Patients Who Leave Without Being Seen in an Academic ED." American 
Journal of Emergency Medicine, vol. 23, no. 3 (2005): 288-94. 

Weiss, S. J., A. A. Ernst, M. R. Sills, B. J. Quinn, A. Johnson, and T. 
G. Nick. "Development of a Novel Measure of Overcrowding in a Pediatric 
Emergency Department." Pediatric Emergency Care, vol. 23, no. 9 (2007): 
641-45. 

Wilper, A. P., S. Woolhandler, K. E. Lasser, D. McCormick, S. L. 
Cutrona, D. H. Bor, and D. U. Himmelstein. "Waits to See an Emergency 
Department Physician: U.S. Trends and Predictors, 1997-2004." Health 
Affairs, vol. 27, no. 2 (2008): w84-w95. 

Zibulewsky, J. "Medical Staff Knowledge of EMTALA at a Large, Tertiary- 
care Hospital." American Journal of Emergency Medicine, vol. 21, no. 1 
(2003): 8-13. 

Commentaries (64 articles): 

"Accelerated Triage Cuts LWBS Rate In Half." ED Management, October 
2005. 

Agrawal, S. "Emergency Department Crowding: An Ethical Perspective." 
Academic Emergency Medicine, vol. 14, no. 8 (2007): 750-51. 

Asplin, B. R. "Does Ambulance Diversion Matter?" Annals of Emergency 
Medicine, vol. 41, no. 4 (2003): 477-80. 

Asplin, B. R. "Hospital-Based Emergency Care: A Future Without 
Boarding?" Annals of Emergency Medicine, vol. 48, no. 2 (2006): 121-25. 

Asplin, B. R. "Measuring Crowding: Time for a Paradigm Shift." Academic 
Emergency Medicine, vol. 13, no. 4 (2006): 459-61. 

Asplin, B. R., and D. J. Magid. "If You Want to Fix Crowding, Start by 
Fixing Your Hospital." Annals of Emergency Medicine, vol. 49, no. 3 
(2007): 273-74. 

Asplin, B. R., D. J. Magid, K. V. Rhodes, L. I. Solberg, N. Lurie, and 
C. A. Camargo, Jr. "A Conceptual Model of Emergency Department 
Crowding." Annals of Emergency Medicine, vol. 42, no. 2 (2003): 173-80. 

Atzema, C., G. Bandiera, M. J. Schull, T. P. Coon, and T. J. Milling, 
Jr. "Emergency Department Crowding: The Effect on Resident Education." 
Annals of Emergency Medicine, vol. 45, no. 3 (2005): 276-81. 

Bitterman, R. A. "EMTALA and the Ethical Delivery of Hospital Emergency 
Services." Emergency Medicine Clinics of North America, vol. 24, no. 3 
(2006): 557-77. 

Blomkalns, A. L., and W. B. Gibler. "Emergency Department Crowding: 
Emergency Physicians and Cardiac Risk Stratification as Part of the 
Solution." Annals of Emergency Medicine, vol. 43, no. 1 (2004): 77-78. 

Brock, E. "Cities Attempt to End Ambulance Diversion." The American 
City & County, vol. 121, no. 11 (2006): 12-14. 

Brousseau, D., and M. Gorelick. "Emergency Department Wait Times." 
Pediatrics, vol. 116, no. 1 (2005): 295. 

Chan, T., J. P. Killeen, D. Kelly, and D. A. Guss. "Impact of Rapid 
Entry and Accelerated Care at Triage on Reducing Emergency Department 
Patient Wait Times, Length of Stay, and Rate of Leaving without Being 
Seen." Annals of Emergency Medicine, vol. 47, no. 3 (2006): 295-96. 

Committee on Pediatric Emergency Medicine. "Overcrowding Crisis in our 
Nation's Emergency Department: Is our Safety Net Unraveling?" 
Pediatrics, vol. 114, no. 3 (2004): 878-88. 

Delaney, D. "Reducing Ambulance Diversions Without Compromising Care." 
American Nurse Today, vol. 2, no. 7 (2007): 15-17. 

Delbridge, T. R., and D. M. Yealy. "Looking for a Solution … to the 
Solution?" Annals of Emergency Medicine, vol. 44, no. 4 (2004): 304-06. 

"Diversion Crisis Eases, But Strategies Still Critical." ED Management, 
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"Diversions Worsening, Trend May Continue." ED Management, April 2006. 

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Hwang, U., and J. Concato. "Care in the Emergency Department: How 
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American College of Emergency Physicians. Emergency Department 
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American College of Emergency Physicians. Emergency Department 
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American College of Emergency Physicians. On-Call Specialist Coverage 
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American College of Emergency Physicians. Report from a Roundtable 
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American Hospital Association. Taking the Pulse. The State of America's 
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American Hospital Association. The 2007 State of America's Hospitals-- 
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American Hospital Association. The State of America's Hospitals--Taking 
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American Medical Association, "Report 3 of the Board of Trustees (I- 
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Bazzoll, G. J., L. R. Brewster, G. Liu, and S. Kuo. "Does U.S. Hospital 
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Burt, C. W., and L. F. McCaig. "Staffing, Capacity, and Ambulance 
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Cunningham, P., and J. May. "Insured Americans Drive Surge in Emergency 
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DeLia, D., Emergency Department Utilization and Surge Capacity in New 
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DeLia, D., Potentially Avoidable Use of Hospital Emergency Departments 
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Emergency Nurses Association. Emergency Nurses Association Position 
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Emergency Nurses Association. ENA 2005 National Emergency Department 
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Institute of Medicine. Future of Emergency Care, Hospital-based 
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Joint Commission Resources. From Front Office to Front Line. Essential 
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Keslar, L., "Sick of Waiting." Proto Magazine, Summer 2008. [hyperlink, 
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McCaig, L. F., and C. W. Burt. "National Hospital Ambulatory Medical 
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McCaig, L. F., and C. W. Burt. "National Hospital Ambulatory Medical 
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McCaig, L. F., and E. W. Nawar. "National Hospital Ambulatory Medical 
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[End of section] 

Footnotes: 

[1] Boarding in the emergency department refers to a patient remaining 
in the emergency department after the decision to admit to the hospital 
or transfer the patient to another facility has been made. 

[2] We did not include articles that were published outside of the 
United States, used subjects or data from outside the United States, 
were only available in an abstract form, focused on issues other than 
day-to-day emergency department operations, or were unrelated to 
emergency department crowding. 

[End of section] 

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