Grant: Knowledge Synthesis Grant

Overcrowding in the emergency department (ED) is a situation when the EDs capacity to deliver appropriate patient care in a timely manner has been exceeded. It has become a chronic and widespread problem across Canada and is associated with poor patient outcomes, including increased risk of death. Many interventions have been suggested to address ED overcrowding, including the creation of short stay/observation units. A short stay unit is a physical location in a hospital, usually in close proximity to the ED. It is used to 'offload' patients who are stable as compared to acute patients who remain in the ED, with the theory that this separation can facilitate flow in the ED and reduce the number of unnecessary hospital admissions. Although there is a growing body of studies that have evaluated short stay units, there is no up-to-date or rigorous assessment of this literature. The accumulating research on short stay units underscores the need for a systematic review in order to assist health care practitioners, hospital managers and administrators, and patients in making evidence based decisions. Systematic reviews are an ideal choice for making sense of a large body of information, and can help to map out areas of uncertainty and identify gaps in research. A systematic review will yield a better understanding of the short stay unit approach aimed at reducing overcrowding in the ED. This knowledge will be helpful in establishing such units across Canada or in determining if another approach should be taken. Finally, it will provide decision makers with the best evidence as to where future research might be most beneficial.