Interventions in overcrowding of emergency departments: an overview of systematic reviews

Authors

  • Roberto José Bittencourt Secretaria de Estado de Saúde do Distrito Federal. Fundação de Ensino e Pesquisa em Ciências da Saúde. Escola Superior de Ciências da Saúde https://orcid.org/0000-0002-6482-5840
  • Angelo de Medeiros Stevanato Secretaria de Estado de Saúde do Distrito Federal. Fundação de Ensino e Pesquisa em Ciências da Saúde. Escola Superior de Ciências da Saúde https://orcid.org/0000-0001-5015-5017
  • Carolina Thomé N. M. Bragança Secretaria de Estado de Saúde do Distrito Federal. Fundação de Ensino e Pesquisa em Ciências da Saúde. Escola Superior de Ciências da Saúde https://orcid.org/0000-0003-2595-7127
  • Leila Bernarda Donato Gottems Secretaria de Estado de Saúde do Distrito Federal. Fundação de Ensino e Pesquisa em Ciências da Saúde. Escola Superior de Ciências da Saúde https://orcid.org/0000-0002-2675-8085
  • Gisele O’Dwyer Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Departamento de Administração e Planejamento em Saúde https://orcid.org/0000-0003-0222-1205

DOI:

https://doi.org/10.11606/s1518-8787.2020054002342

Keywords:

Emergency Service, Hospital, Hospital Administration, Systematic Review

Abstract

OBJECTIVE: To present an overview of systematic reviews on throughput interventions to solve the overcrowding of emergency departments. METHODS: Electronic searches for reviews published between 2007 and 2018 were made on PubMed, Cochrane Library, EMBASE, Health Systems Evidence, CINAHL, SciELO, LILACS, Google Scholar and the CAPES periodicals portal. Data of the included studies was extracted into a pre-formatted sheet and their methodological quality was assessed using AMSTAR 2 tool. Eventually, 15 systematic reviews were included for the narrative synthesis. RESULTS: The interventions were grouped into four categories: (1) strengthening of the triage service; (2) strengthening of the ED’s team; (3) creation of new care zones; (4) change in ED’s work processes. All studies observed positive effect on patient’s length of stay, expect for one, which had positive effect on other indicators. According to AMSTAR 2 criteria, eight revisions were considered of high or moderate methodological quality and seven, low or critically low quality. There was a clear improvement in the quality of the studies, with an improvement in focus and methodology after two decades of systematic studies on the subject. CONCLUSIONS: Despite some limitations, the evidence presented on this overview can be considered the cutting edge of current scientific knowledge on the topic.

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Published

2020-07-27

Issue

Section

Review

How to Cite

Bittencourt, R. J., Stevanato, A. de M., Bragança, C. T. N. M., Gottems, L. B. D., & O’Dwyer, G. (2020). Interventions in overcrowding of emergency departments: an overview of systematic reviews. Revista De Saúde Pública, 54, 66. https://doi.org/10.11606/s1518-8787.2020054002342