Frequency, determinants and impact of overcrowding in emergency departments in Canada: a national survey

Healthc Q. 2007;10(4):32-40. doi: 10.12927/hcq.2007.19312.


Several reports have documented the prevalence and severity of emergency department (ED) overcrowding at specific hospitals or cities in Canada; however, no study has examined the issue at a national level. A 54-item, self-administered, postal and web-based questionnaire was distributed to 243 ED directors in Canada to collect data on the frequency, impact and factors associated with ED overcrowding. The survey was completed by 158 (65% response rate) ED directors, 62% of whom reported overcrowding as a major or severe problem during the past year. Directors attributed overcrowding to a variety of issues including a lack of admitting beds (85%), lack of acute care beds (74%) and the increased length of stay of admitted patients in the ED (63%). They perceived ED overcrowding to have a major impact on increasing stress among nurses (82%), ED wait times (79%) and the boarding of admitted patients in the ED while waiting for beds (67%). Overcrowding is not limited to large urban centres; nor is it limited to academic and teaching hospitals. The perspective of ED directors reinforces the need for further examination of effective policies and interventions to reduce ED overcrowding.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Canada
  • Crowding*
  • Emergency Service, Hospital / organization & administration*
  • Health Care Surveys*
  • Humans
  • National Health Programs