AAP: Reducing crowding in emergency departments


In a new policy statement, the American Academy of Pediatrics has provided guidelines on reducing crowding in emergency departments.

The American Academy of Pediatrics (AAP) has released guidance for reducing crowding in emergency departments (EDs) to improve quality of care, patient safety, patient experience, and health of populations.

During the winter, surges of COVID-19, influenza, and respiratory syncytial virus led to crowding in hospitals, causing bed shortages and long waits for care. The rise in mental health care needs in children and adolescents has also contributed to crowding in hospitals, with a noticeable rise in children and adolescents seeking ED care even before 2022.

Noting the need for a coordinated effort across the health care delivery system to reduce crowding in EDs, the AAP has released guidelines titled “Crowding in the Emergency Department: Challenges and Recommendations for the Care of Children,” published in the March 2023 issue of Pediatrics.

“Emergency departments serve as a safety net for health care in many communities,” said Toni K. Gross, MD, MPH, FAAP, lead author of the policy statement. “They need to be readily available to provide emergency care not only on a regular basis but in cases of disasters or pandemics.”

According to Gross, providing emergency care in these situations will not only require coordination across the health care system, but helping patients with chronic conditions access care in outpatient settings as well.

The primary concern is patient safety, according to the AAP Committee on Pediatric Emergency Medicine. A primary contributor to crowding is believed to be holding an admitted patient in the ED, often because of limited staffed hospital beds.

The recommendations include an integration of mental health care into primary care pediatrics, support for accessible outpatient resources, non-traditional outpatient service hours, use of telemedicine to access medical care, and encouragement and assistance for families to enroll for health care coverage, along with reducing barriers to enrollment.


American Academy of Pediatrics offers guidance on reducing crowding in emergency departments. American Academy of Pediatrics. February 20, 2023. Accessed March 6, 2023. https://www.aap.org/en/news-room/news-releases/aap/2022/american-academy-of-pediatrics-offers-guidance-on-reducing-crowding-in-emergency-departments/

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