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Instalasi Gawat Darurat (IGD) rumah sakit merupakan unit krusial yang sering mengalami kepadatan pasien, yaitu kondisi ketika jumlah pasien yang datang per satuan waktu melebihi kapasitas sumber daya dan ruang yang tersedia. Kepadatan ini berdampak pada penurunan kualitas pelayanan, peningkatan risiko keselamatan pasien, serta peningkatan beban kerja tenaga kesehatan. Studi ini bertujuan untuk meninjau faktor-faktor penyebab kepadatan dan dampaknya terhadap sistem pelayanan di IGD rumah sakit berdasarkan literature review. Penelitian ini merupakan studi literature review yang menggunakan sumber dari database PubMed, Scopus, dan Google Scholar dengan rentang tahun 2019–2024. Sebanyak 15 artikel dipilih berdasarkan kriteria inklusi dan eksklusi yang telah ditentukan. Faktor penyebab kepadatan pasien di Instalasi Gawat Darurat (IGD) rumah sakit diklasifikasikan dalam tiga kelompok: input (kasus non-darurat, jumlah pendamping yang berlebihan, dan usia lanjut), throughput (tingginya pemeriksaan penunjang diagnostik, konsultasi dokter spesialis, kurangnya tempat tidur di IGD), dan output (bed block, keterlambatan transfer pasien). Dampak dari kepadatan pasien di Instalasi Gawat Darurat (IGD) rumah sakit antara lain pelatihan residen menurun, stress dan kelelahan pada tenaga kesehatan, meningkatnya kekerasan terhadap staf di IGD, dan kecemasan pasien. Kepadatan pasien di Instalasi Gawat Darurat (IGD) rumah sakit merupakan masalah kompleks yang perlu ditangani secara sistematis melalui perbaikan manajemen pelayanan, alokasi sumber daya, serta penguatan sistem rujukan dan layanan primer. Studi ini dapat menjadi dasar bagi pengambil kebijakan untuk merumuskan strategi penanggulangan kepadatan Instalasi Gawat Darurat (IGD) di rumah sakit.
The hospital Emergency Department (ED) is a crucial unit that often experiences patient congestion, a condition when the number of patients arriving per unit of time exceeds the capacity of available resources and space. This congestion has an impact on decreasing the quality of service, increasing the risk of patient safety, and increasing the workload of health workers. This study aims to review the factors causing congestion and its impact on the service system in the hospital ED based on a literature review. This study is a literature review study using sources from the PubMed, Scopus, and Google Scholar databases with a period of 2019–2024. A total of 15 articles were selected based on predetermined inclusion and exclusion criteria. Factors causing patient congestion in the hospital ED are classified into three groups: input (non-emergency cases, excessive number of companions, and elderly), throughput (high diagnostic support examinations, specialist doctor consultations, lack of beds in the ED), and output (bed block, delays in patient transfers). The impacts of patient density in the Emergency Department (ED) of hospitals include decreased resident training, stress and fatigue in health workers, increased violence against staff in the ED, and patient anxiety. Patient density in the Emergency Department (ED) of hospitals is a complex problem that needs to be addressed systematically through improving service management, resource allocation, and strengthening the referral system and primary services. This study can be a basis for policy makers to formulate strategies to overcome the density of the Emergency Department (ED) in hospitals
Crowding conditions in the Emergency Unit has become a global issue in all health care systems for more than two decades. This is due to a high number of boarding times which causes an accumulation number of patients in the ER. The purpose of this study sought was to determine the factors associated with boarding time delays in the emergency department. The researcher used a literature review as a method and used Pubmed, Scopus, Proquest, Google Scholar, and UI Library databases which produces 15 included articles, and articles published in the last ten years, discussing factors related to boarding time delays in the emergency department, and articles with quantitative methods. , qualitative, and mix-method. The results of the included study from 15 articles resulted in several causes of delays in boarding time in the ER, including the availability of beds caused by the patient's unplanned return and taking 118 minutes (2 hours) longer than the planned return. The limited number of health workers not only causes an increase in boarding time but also reduces health services and patient safety. The patient's diagnosis time in the ER takes longer because doctors need to collect more data to make a patient's diagnosis. Patients who enter the ER are patients with high emergencies, the more emergency requires a longer diagnosis and increases the boarding time in the ER. The availability of special wards takes a lot of time at boarding time because apart from requiring special treatment, the number of special wards is also limited. The high level of hospital capacity also increases the number of boarding times because patients have to wait for health services due to queuing, thereby increasing the number of boarding times. Consultations between patients and doctors occur in the ER for patients with high emergencies, because before taking action, doctors need to know more about the pain experienced by the patient. It can be concluded that the factors related to the delay in boarding time at hospital are availability of beds, limited number of health workers, time of patient diagnosis, level of emergency, availability of special wards, high level hospital capacity, and number of consuls with specialist doctors. Therefore, it is necessary to conduct a study on the standard boarding time in the emergency department at the hospital.
