Lots of ways to reduce over-crowding, most of which are unpalatable to anyone including those who complain repeatedly.
For example - stop bulk billing ED presentations unless someone is admitted to the hospital or at least referred to a specialist. This will prevent people using ED's like GP clinics for basic needs like scripts, medical certificates, minor ailments like uncomplicated UTI's and ingrown nails, cut fingers etc.
But then the last thing you want to do is actually deny people access to care.
The other thing to do is try to send people home as quickly as possible, which is what the ED has done with this poor lady who I can only empathise with. Bottom line here is she is 83, has had a 'clinical stroke' (ie diagnosed based on clear presenting symptoms, not with computed tomography or other radiological imaging) and her potential to recover and rehabilitate when she's already living in a nursing home is virtually nil. Hospitals have healthcare workers in them, not miracle workers. Admission to a hospital will provide minimal benefit because the ceiling of care or intervention is so low - you can't or wouldn't ethically do neurosurgery on her, you won't do CPR if she becomes unresponsive because her chance of meaningful survival is less than 1%, in fact if she deteriorates the best thing for her would be to go painlessly and quickly - this is always preferable at home where people are familiar with staff/family and more comfortable, not in foreign environments with strangers. Nursing homes have staff trained to do this and all hospitals have community services that can assist in the process at home.
Like I said, all unpalatable solutions.
The hospital system has been broken since I walked into it in 2009 and not a single state or federal government has managed to do anything to fix it. It constantly runs at or above 100% capacity so the potential for 'surge workload' is non-existent. Hospitals cost billions to build, hundreds of millions to extend, and training for even the most basic staff takes two years but at least 4-6 for most disciplines.
