Hospital overcrowding is a major issue for many hospitals. It affects patient outcomes, satisfaction, and staff morale. It also causes delays in the diagnosis and treatment of patients. Overcrowding has been linked to poorer patient and nurse outcomes.

The problem is caused by a mismatch between the demand and supply of hospital beds. The problem is exacerbated by patient boarding, which occurs when a patient requiring inpatient care cannot be admitted to a hospital bed because of overcrowding in the emergency department. Patient boarding is associated with high rates of leaving against medical advice (LWBS), which leads to poorer outcomes. It has also been found to increase the time it takes for a patient to be triaged, which is known as door-to-needle delay.

ED overcrowding is often seen as a matter of increasing the number and efficiency of ED staff, but this may not be sufficient to alleviate the problem. Overcrowding is also a result of a lack of hospital resources, such as beds and physicians. Moreover, patient flow in the hospital is often affected by factors outside of the control of the ED, such as lack of operating room capacity, delays in patient admissions and discharges, and inpatient bed availability.

An important cause of ED overcrowding is a symptom-driven approach to patients and a lack of understanding about the nature of medical illnesses. For example, patients who come to the ED complaining of chest pains are often reassured by their physician and may not be admitted because they are not severe enough.