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Virginia Ahalt, Nilay Tanık Argon, Serhan Ziya, Jeff Strickler, Abhi Mehrotra
According to American College of Emergency Physicians, emergency department (ED) crowding occurs when the identified need for emergency services exceeds available resources for patient care in the ED, hospital, or both. ED crowding is a widely reported problem and several crowding scores are proposed to quantify crowding using hospital and patient data as inputs for assisting healthcare professionals in anticipating imminent crowding problems. Using data from a large academic hospital in North Carolina, we evaluate three crowding scores, namely, EDWIN, NEDOCS, and READI by assessing strengths and weaknesses of each score, particularly their predictive power...
October 4, 2016: Health Care Management Science
Nese Colak Oray, Sedat Yanturali, Ridvan Atilla, Gurkan Ersoy, Hakan Topacoglu
OBJECTIVES: Emergency department (ED) crowding is a growing problem across the world. Hospitals need to identify the situation using emergency department crowding scoring systems and to produce appropriate solutions. METHODS: A new program (Electronic Blockage System, EBS) was written supplementary to the Hospital Information System. It was planned that the number of empty beds in the hospital should primarily be used for patients awaiting admission to a hospital bed at the ED...
June 2014: Turkish Journal of Emergency Medicine
Tiffani J Johnson, Robert W Hickey, Galen E Switzer, Elizabeth Miller, Daniel G Winger, Margaret Nguyen, Richard A Saladino, Leslie R M Hausmann
OBJECTIVES: The emergency department (ED) is characterized by stressors (e.g., fatigue, stress, time pressure, and complex decision-making) that can pose challenges to delivering high-quality, equitable care. Although it has been suggested that characteristics of the ED may exacerbate reliance on cognitive heuristics, no research has directly investigated whether stressors in the ED impact physician racial bias, a common heuristic. We seek to determine if physicians have different levels of implicit racial bias post-ED shift versus preshift and to examine associations between demographics and cognitive stressors with bias...
March 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Adrian Boyle, Gary Abel, Pramin Raut, Richard Austin, Vijayasankar Dhakshinamoorthy, Ravi Ayyamuthu, Iona Murdoch, Joel Burton
INTRODUCTION: There is uncertainty about the best way to measure emergency department crowding. We have previously developed a consensus-based measure of crowding, the International Crowding Measure in Emergency Departments (ICMED). We aimed to obtain pilot data to evaluate the ability of a shortened form of the ICMED, the sICMED, to predict senior emergency department clinicians' concerns about crowding and danger compared with a very well-studied measure of emergency department crowding, the National Emergency Department Overcrowding Score (NEDOCS)...
May 2016: Emergency Medicine Journal: EMJ
Grant Wei, Rajiv Arya, Z Trevor Ritz, Albert S He, Pamela A Ohman-Strickland, Jonathan V McCoy
INTRODUCTION: The effect of emergency department (ED) crowding has been recognized as a concern for more than 20 years; its effect on productivity, medical errors, and patient satisfaction has been studied extensively. Little research has reviewed the effect of ED crowding on medical education. Prior studies that have considered this effect have shown no correlation between ED crowding and resident perception of quality of medical education. OBJECTIVE: To determine whether ED crowding, as measured by the National ED Overcrowding Scale (NEDOCS) score, has a quantifiable effect on medical student objective and subjective experiences during emergency medicine (EM) clerkship rotations...
November 2015: Western Journal of Emergency Medicine
Anita Sabzghabaei, Majid Shojaee, Hossein Alimohammadi, Hojjat Derakhshanfar, Parvin Kashani, Shohreh Nassiriabrishamchi
INTRODUCTION: Creating a calm and stress-free environment affects education significantly. The effects of the emergency department overcrowding (EDO) on the training of emergency medicine residents (EMR) is a highly debated subject. Therefore, this study aimed to evaluate the effect of EDO on efficiency of EMR's education. METHODS: In this cross-sectional study, the effects of overcrowding on EMR's education in the resuscitation room and acute care unit. Data collection was done using a questionnaire, which was filled out by the second year EMRs...
2015: Emergency (Tehran, Iran)
Celestino Todisco
Overcrowding in Emergency Departments represents one of the main concerns in effective hospital management today. In order to reduce this phenomenon, this study experimented with a new organizational model that exploited available resources, without incurring additional costs. Through the redistribution of hospital beds, it was possible to reduce access blocks in the Emergency Department of the test hospital. The observational period of this study was of 120 days, and daily surveys of crowding were performed at predetermined intervals...
2015: Acta Bio-medica: Atenei Parmensis
Hao Wang, Richard D Robinson, Kellie Bunch, Charles A Huggins, Katherine Watson, Rani D Jayswal, Noah C White, Brett Banks, Nestor R Zenarosa
BACKGROUND: Emergency department (ED) crowding has become more common, and perceptions of crowding vary among different health care providers. The National Emergency Department Overcrowding Study (NEDOCS) tool is the most commonly used tool to estimate ED crowding but still uncertain of its reliability in different ED settings. OBJECTIVE: The objectives of this study are to determine the accuracy of using the NEDOCS tool to evaluate overcrowding in an extremely high-volume ED and assess the reliability and consistency of different providers' perceptions of ED crowding...
October 2014: American Journal of Emergency Medicine
Peter W Crane, Yuan Zhou, Yifan Sun, Li Lin, Sandra M Schneider
BACKGROUND: Emergency department (ED) crowding correlates with patient safety. Difficulties quantifying crowding and providing solutions were highlighted in the recent Institute of Medicine (IOM) report calling for the application of advanced industrial engineering (IE) research techniques to evaluate ED crowding. ED personnel workload is a related concept, with potential reciprocal effects between the two. Collaboration between emergency medicine and IE is needed to address crowding and ED personnel workload...
April 2014: Journal of Emergency Medicine
Martijn Anneveld, Christien van der Linden, Diana Grootendorst, Martha Galli-Leslie
BACKGROUND: Overcrowding in the emergency department (ED) is an increasing problem worldwide. In The Netherlands overcrowding is not a major issue, although some urban hospitals struggle with increased throughput. In 2004, Weiss et al. created the NEDOCS tool (National Emergency Department Over Crowding Study), a web-based instrument to measure objective overcrowding with scores between 0 (not busy at all) to above 181 (disaster). In this study we tried to validate the accuracy of the NEDOCS tool by comparing this with the subjective feelings of the ED nurse and emergency physician (EP) in an inner city hospital in The Netherlands...
2013: International Journal of Emergency Medicine
Derek R Cooney, Harry Wallus, Michael Asaly, Susan Wojcik
BACKGROUND: Use of backboards as part of routine trauma care has recently come into question because of the lack of data to support their effectiveness. Multiple authors have noted the potential harm associated with backboard use, including iatrogenic pain, skin ulceration, increased use of radiographic studies, aspiration and respiratory compromise. An observational study was performed at a level 1 academic trauma center to determine the total and interval backboard times for patients arriving via emergency medical services (EMS)...
2013: International Journal of Emergency Medicine
Derek R Cooney, Susan Wojcik, Naveen Seth, Corey Vasisko, Kevin Stimson
BACKGROUND: Ambulance offload delay (AOD) has been recognized by the National Association of EMS Physicians (NAEMSP) as an important quality marker. AOD is the time between arrival of a patient by EMS and the time that the EMS crew has given report and moved the patient off of the EMS stretcher, allowing the EMS crew to begin the process of returning to service. The AOD represents a potential delay in patient care and a delay in the availability of an EMS crew and their ambulance for response to emergencies...
2013: International Journal of Emergency Medicine
John R Richards, Gal Ozery, Mark Notash, Peter E Sokolove, Robert W Derlet, Edward A Panacek
Objective. The boarding of patients in Emergency Department (ED) hallways when no inpatient beds are available is a major cause of ED crowding. One solution is to board admitted patients in an inpatient rather than ED hallway. We surveyed patients to determine their preference and correlated their responses to real-time National Emergency Department Overcrowding Score (NEDOCS). Methods. This was a survey of admitted patients in the ED of an urban university level I trauma center serving a community of 5 million about their personal preferences regarding boarding...
2011: Emergency Medicine International
Ching-Chi Lee, Nan-Yao Lee, Ming-Che Chuang, Po-Lin Chen, Chia-Ming Chang, Wen-Chien Ko
OBJECTIVES: This study aims to determine the risk factors associated with the bacterial contamination of blood cultures among adults visiting the emergency department (ED). METHODS: Clinical variables and medical records of adults with bacterial growth of blood cultures in the ED as well as the degree of ED crowding, between August 2007 and July 2008, were prospectively collected. RESULTS: Of the 11 491 adults who underwent blood culture sampling, the medical records of 558 (4...
July 2012: American Journal of Emergency Medicine
Aaron E Bair, Wheyming T Song, Yi-Chun Chen, Beth A Morris
In this study, a discrete-event simulation approach was used to model Emergency Department's (ED) patient flow to investigate the effect of inpatient boarding on the ED efficiency in terms of the National Emergency Department Crowding Scale (NEDOCS) score and the rate of patients who leave without being seen (LWBS). The decision variable in this model was the boarder-released-ratio defined as the ratio of admitted patients whose boarding time is zero to all admitted patients. Our analysis shows that the Overcrowded(+) (a NEDOCS score over 100) ratio decreased from 88...
October 2010: Journal of Medical Systems
Steven J Weiss, Amy A Ernst, Marion R Sills, Bruce J Quinn, Ashira Johnson, Todd G Nick
OBJECTIVE: Emergency department (ED) overcrowding has been quantified with a scale that reflects the degree of overcrowding (National ED Overcrowding Scale, or NEDOCS) in general academic EDs. However, validity of the 5-question NEDOCS scale has not been established for a pediatric ED. Our primary objectives were to validate the NEDOCS model in our institution's pediatric ED and explore the possibility of another pediatric ED overcrowding model that would be better than the NEDOCS model...
September 2007: Pediatric Emergency Care
Nathan R Hoot, Chuan Zhou, Ian Jones, Dominik Aronsky
STUDY OBJECTIVE: We quantified the potential for monitoring current and near-future emergency department (ED) crowding by using 4 measures: the Emergency Department Work Index (EDWIN), the National Emergency Department Overcrowding Scale (NEDOCS), the Demand Value of the Real-time Emergency Analysis of Demand Indicators (READI), and the Work Score. METHODS: We calculated the 4 measures at 10-minute intervals during an 8-week study period (June 21, 2006, to August 16, 2006)...
June 2007: Annals of Emergency Medicine
Nathan Hoot, Dominik Aronsky
Overcrowding of emergency departments impedes health care access and quality nationwide. A real-time early warning system for overcrowding may allow administrators to alleviate the problem before reaching a crisis state. Two original probabilistic models - a logistic regression and a recurrent neural network - were created to predict overcrowding crises one hour in the future. The two original and two pre-existing models were validated at 8,496 observation points from January 1, 2006 to February 28, 2006. All models showed high discriminatory ability in terms of area under the receiver operating characteristic curve (logistic regression = ...
2006: AMIA ... Annual Symposium Proceedings
Spencer S Jones, Todd L Allen, Thomas J Flottemesch, Shari J Welch
BACKGROUND: Emergency department (ED) overcrowding has become a frequent topic of investigation. Despite a significant body of research, there is no standard definition or measurement of ED crowding. Four quantitative scales for ED crowding have been proposed in the literature: the Real-time Emergency Analysis of Demand Indicators (READI), the Emergency Department Work Index (EDWIN), the National Emergency Department Overcrowding Study (NEDOCS) scale, and the Emergency Department Crowding Scale (EDCS)...
November 2006: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Kamini Raj, Kylie Baker, Stephan Brierley, Duncan Murray
OBJECTIVE: To determine the accuracy and usefulness of the National Emergency Department Overcrowding Study (NEDOCS) tool in an urban hospital ED in Australia by direct comparison with subjective assessment by senior ED staff. METHOD: A sample of simultaneous subjective and objective data pairs were collected six times a day for a period of 3 weeks. All senior medical staff in the ED answered a brief questionnaire along with the senior charge nurse for the ED. Simultaneously, the senior charge nurse also documented the total number of patients in the ED, the number of patients awaiting admission, the number of patients on ventilators, the longest time waited by an ED patient for ward bed, and the waiting time for the last patient from the Waiting Room placed on a trolley...
June 2006: Emergency Medicine Australasia: EMA
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