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Emergency department overcrowding is a critical issue affecting healthcare systems worldwide. This scoping review synthesizes evidence from successful improvement projects focused on operational excellence. A systematic review of 34 articles published between 2014 and 2024 was conducted. The articles were categorized into three main themes: Lean Six Sigma, improvement science, and clinical governance. Although these approaches often overlap, they are presented separately for clarity. The review offers an in-depth analysis of strategies proven to improve patient flow, reduce waiting times, and optimize resource utilization in emergency departments, addressing overcrowding and enhancing overall efficiency.
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Fernandes et al. (2026) studied this question.
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