Introduction
This page presents interventions for decision-makers to consider as part of step 2 of the Evidence Navigation Guide of HTERP’s guidance to inform decision- and policy-making to alleviate emergency department (ED) overcrowding. The interventions are based on expert opinion and evidence reviews conducted by us and are organized into 5 categories:
- Input interventions are related to the need for ED services and how and whether people access the ED
- Throughput interventions are implemented within the ED
- Output interventions are related to leaving the ED for inpatient care, outpatient care, or home
- Systemic interventions are outside the ED or address factors outside the ED
- Multicomponent interventions combine 2 or more interventions
Within each category are 3 or 4 tables that list the interventions and include links to the evidence sources. An intervention may be repeated in the same table or multiple tables and show different intervention effectiveness if more than 1 evidence source was reviewed for that intervention.
- Interventions with promise: Based on evidence and expert input, interventions that show promise to alleviate ED overcrowding if aligned with the main contributing factors to ED overcrowding in a specific context and with consideration of whether implementation fidelity is possible.
- Moderate- and high-quality conclusive evidence: Interventions identified from systematic reviews with certain evidence or evidence with some uncertainty (moderate or high certainty) that is moderate or high quality based on AMSTAR 2 ratings.
- New and emerging interventions: Interventions that are new or are not yet in wide use in EDs and health systems internationally and across Canada identified from articles, reports, conference abstracts, clinical trial registries, and other public sources of information (e.g., hospital websites).
- Inconclusive, unfavourable, or low-quality evidence: Interventions identified from systematic reviews with evidence that is very uncertain (has low or very low certainty), that has an unfavourable effect on outcomes versus a comparator, or is low quality based on AMSTAR 2 ratings