Emergency department overcrowding and mortality after the introduction of the 4-hour rule in Western Australia

Biswadev Mitra and Peter A Cameron
Med J Aust 2012; 196 (8): . || doi: 10.5694/mja12.10315
Published online: 7 May 2012

To the Editor: We would like to congratulate Geelhoed and de Klerk1 for reporting the expected decreases in emergency department (ED) overcrowding following introduction of the 4-hour rule in Western Australia. Their study highlighted potential adverse effects and inflated demand across hospital systems — specifically, concerns regarding patient safety and junior medical staff training; significantly higher proportions of admitted patients (39.6% to 49.1%); and incomplete assessment and management in EDs, underscored by “more . . . investigations occurring on the wards”.

  • Biswadev Mitra
  • Peter A Cameron

  • Alfred Hospital, Melbourne, VIC.


Competing interests:

No relevant disclosures.


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