REMCS: Emergency Department Crowding and Boarding, Healthcare System Preparedness and Surge Capacity 

Despite calls for reducing crowding and the Institute of Medicine’s appeal to end the boarding of admitted patients, emergency department (ED) crowding continues to worsen in U.S. hospitals. While there has been a proliferation of proven interventions to reduce ED and hospital crowding and boarding, many hospitals do not have a strategy to address the crowding issue locally. To improve quality and performance, measurement of hospitals and healthcare systems related to crowding and boarding is needed for public reporting and accountability purposes. This report discusses priority areas and reviews issues to consider in the development of candidate voluntary consensus standards for hospitals, healthcare systems and regions in the areas of ED and hospital crowding including, boarding and diversion, emergency preparedness, and surge capacity.