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Boarding causes ER overcrowding, raises risk for patient injury

Iowa residents may notice the next time they enter an emergency room that it's unusually crowded. Overcrowding in ERs has been an issue for more than a decade. The Institute of Medicine made a report on it back in 2007, saying that overcrowding raises the risk for patient injury through delays in treatment, the delayed administration of drugs and diagnostic errors. Patients may suffer from excessively long hospital stays as a result.

There are many factors that contribute to overcrowding, such as the declining number of hospitals in the U.S. since the 1970s and the growing habit people have of visiting the ER for primary care. One stand-out factor, though, is the practice of boarding: forcing patients with a scheduled treatment to wait in the ER, sometimes for hours, before a bed becomes available.

The Institute of Medicine did, in fact, warn about this practice in its 2007 report. Boarding significantly lowers the quality of care, yet many hospitals will do nothing about it because they do not want to restrict the cash flow that comes from certain procedures. For example, Medicare's reimbursement rates clearly favor elective procedures and invasive surgeries over the management of medical conditions. Many ER patients who require the latter, then, will face conflicts with scheduling and bed availability.

The matter is more complicated than this summary makes it sound, but nevertheless, medical errors and harmful delays should not happen. When they do and are clearly the result of negligence, then those who are injured by the act may have grounds for a claim under medical malpractice law. It may be a good idea to have legal representation. A lawyer may hire third parties to investigate the matter, and medical experts might come in to measure the extent of the injuries.

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