Of course multi-tasking and prioritizing in hectic situations are core skills of emergency medicine, and no one would argue that an ER will ever be free of distraction. Part of the difficulty in studying this problem involves establishing metrics for overcrowding and education in the first place. But what remains clear is that continuing to push emergency departments beyond capacity will produce negative outcomes not just in the short term for those patients stuck on stretchers or out in the waiting room, but far into the future as well.
-J Fischer et al., "Overcrowding: Harming the Patients of Tomorrow?" Academic Emergency Medicine, 16(1): 56-60, January 2009.