Association between Covid-19 surge and emergency department patient flow and experience.

The study was done in one level-one hospital in the Netherlands, where patients have 24/7 primary care, so it may not apply elsewhere. The respiratory group was defined by triage as shortness of breath, which may miss patients with suspected Covid-19 who had fever or abdominal complaints. The 2019 comparison period included a severe influenza season, so differences between years may reflect flu as well as pandemic preparations. The survey response rate was 35.7%, and 2020 surveys were by phone while earlier comparisons were face-to-face, so year-to-year experience comparisons were hypothesis generating. The study was descriptive and retrospective, so it shows associations in patient flow and experience, not that any preparation caused the change. Crowding measured by NEDOCS does not necessarily match nursing workload. The analysis did not include whether patients were isolated, tested, or how many staff-patient interactions occurred.

The study received no specific grant, and the authors declared no competing financial interests or personal relationships.

Do not conclude that lower crowding improved patient experience. Overall experience stayed similar, and many surveyed patients reported problems with involvement in decisions and discharge information.