Hospital capacity: what is the measure and what is the goal?

We need those not directly in the firing line to appreciate the evidence on overcrowding

Resolving access block and emergency department (ED) overcrowding is finally front and centre of the political agenda. Governments have heeded calls for action and responded by announcing a national access target to improve timely treatment in Australian EDs. After the target is implemented, “anyone presenting to a public hospital emergency department will be admitted, referred for treatment or discharged within four hours of presentation, where it is clinically appropriate to do so”.1 In the United Kingdom, a similar 4-hour target has been in place since 2004, and, despite a recent policy announcement concerning its abolition from April 2011, timeliness of care and avoidance of delay once a patient is ready to move to a ward “will always remain an important element of any balanced approach to quality”.2