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https://www.readbyqxmd.com/read/29207925/quantifying-emergency-department-crowding-comparison-between-two-scores
#1
Jérôme Jobé, Anne-Françoise Donneau, Béatrice Scholtes, Alexandre Ghuysen
INTRODUCTION: Emergency department (ED) crowding is a major international concern with a negative impact on both patient care and providers. Currently, there is no consensus regarding measure of crowding. Therefore, emergency physicians have to choose between numerous scoring systems, from simple to more complex. The aim of the present study was to compare the complex National Emergency Department Overcrowding Scale (NEDOCS) with the simple ED Occupancy rate (OR) determination. We further evaluated the correlation between these scores and a qualitative assessment of crowding...
December 5, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29175310/no-more-code-black-intervention-to-improve-inpatient-flow-at-a-large-public-hospital
#2
Charles E Coffey, Valda Carter, Eric Wei, Douglas Hutcheon, John P Gruen, Annie Anonas-Ternate, Rebecca Sandoval, Annie Marquez, Laura Sarff, Brad Spellberg
Code Black is a documentary movie, and now television series, whose name derives from a term used to describe critical hospital overcrowding resulting in dangerously inadequate patient flow. The Los Angeles County + University of Southern California (LAC+USC) Medical Center is a large, urban, public hospital with a long history of spending substantial amounts of time in Code Black-indeed the movie was created by a former Emergency Medicine resident at LAC+USC Medical Center. To change years of inadequate inpatient flow, we implemented time-limited cardiac monitoring criteria and empowered existing staff to enforce admission and downgrade criteria for our telemetry, step-down care unit, and intensive care units...
November 21, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29170337/40%C3%A2-ed-crowding-the-acceptability-of-dysfunction
#3
Karl Kavanagh, Darragh Shields, Paul Staunton
BACKGROUND: Crowding in the Emergency Department is internationally recognised as one of the greatest challenges to healthcare provision. Numerous studies have highlighted the ill-effects of crowding, including increased length of stay, mortality and cost per admission. Crowding is typically a manifestation of a hospital at full capacity and its main contributor is the practice of boarding patients in the ED. Therefore, a functioning flow system is advised to ease the burden. Different predictive tools/algorithms assess the degree of crowding...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29038668/overcrowding-and-its-association-with-patient-outcomes-in-a-median-low-volume-emergency-department
#4
J Laureano Phillips, Bradford E Jackson, Elizabeth L Fagan, Steven E Arze, Brenton Major, Nestor R Zenarosa, Hao Wang
BACKGROUND: Crowding occurs commonly in high volume emergency departments (ED) and has been associated with negative patient care outcomes. We aim to assess ED crowding in a median-low volume setting and evaluate associations with patient care outcomes. METHODS: This was a prospective single-center study from November 14, 2016 until December 14, 2016. ED crowding was measured every 2 h by three different estimation tools: National Emergency Department Overcrowding Score (NEDOCS); Community Emergency Department Overcrowding Score (CEDOCS); and Severely-overcrowding Overcrowding and Not-overcrowding Estimation Tool (SONET) categorized under six different levels of crowding (not busy, busy, extremely busy, overcrowded, severely overcrowded, and dangerously overcrowded)...
November 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28992161/the-role-of-patient-perception-of-crowding-in-the-determination-of-real-time-patient-satisfaction-at-emergency-department
#5
Hao Wang, Jeffrey A Kline, Bradford E Jackson, Richard D Robinson, Matthew Sullivan, Marcus Holmes, Katherine A Watson, Chad D Cowden, Jessica Laureano Phillips, Chet D Schrader, JoAnna Leuck, Nestor R Zenarosa
Objective: To evaluate the associations between real-time overall patient satisfaction and Emergency Department (ED) crowding as determined by patient percepton and crowding estimation tool score in a high-volume ED. Design: A prospective observational study. Setting: A tertiary acute hospital ED and a Level 1 trauma center. Participants: ED patients. Intervention(s): Crowding status was measured by two crowding tools [National Emergency Department Overcrowding Scale (NEDOCS) and Severely overcrowded-Overcrowded-Not overcrowded Estimation Tool (SONET)] and patient perception of crowding surveys administered at discharge...
October 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28924304/nedocs-vs-subjective-evaluation-%C3%A2-is-the-health-personnel-of-the-emergency-department-aware-of-its-overcrowding
#6
Mauricio Garcia-Romero, Claudia Geraldine Rita-Gáfaro, Jairo Quintero-Manzano, Anderson Bermon Angarita
INTRODUCTION: An emergency department (ED) is considered to be "overcrowded" when the number of patients exceeds its treatment capacity and it does not have the conditions to meet the needs of the next patient to be treated. This study evaluates overcrowding in the emergency department of a hospital in Colombia. OBJECTIVE: To compare the objective NEDOCS scale with a subjective evaluation by ED health staff in order to evaluate the differences between the two. METHODS: The NEDOCS scale was applied and a subjective overcrowding survey was administered to the medical staff and the charge nurse on duty 6 times per day (6:00 a...
June 30, 2017: Colombia Médica: CM
https://www.readbyqxmd.com/read/28898330/-analysis-of-crowding-in-an-adult-emergency-department-of-a-tertiary-university-hospital
#7
Diego Hernán Giunta, Ana Soledad Pedretti, Cristina María Elizondo, María Florencia Grande Ratti, Fernán González Bernaldo de Quiros, Gabriel Darío Waisman, Hector José Peroni, Bernardo Martínez
BACKGROUND: Crowding in Emergency Departments (ED), results from the imbalance between the simultaneous demand for health care and the ability of the system to respond. The NEDOCS scale (National Emergency Department Crowding Scale) measures the degree of crowding in an ED. AIM: To describe ED Crowding characteristics, using the NEDOCS scale, in an Argentinean hospital. MATERIAL AND METHODS: A retrospective cohort study was conducted with all adult patient consultations between July 2013 and July 2014 at the ED of Hospital Italiano de Buenos Aires...
May 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28688771/optimal-measurement-interval-for-emergency-department-crowding-estimation-tools
#8
Hao Wang, Rohit P Ojha, Richard D Robinson, Bradford E Jackson, Sajid A Shaikh, Chad D Cowden, Rath Shyamanand, JoAnna Leuck, Chet D Schrader, Nestor R Zenarosa
STUDY OBJECTIVE: Emergency department (ED) crowding is a barrier to timely care. Several crowding estimation tools have been developed to facilitate early identification of and intervention for crowding. Nevertheless, the ideal frequency is unclear for measuring ED crowding by using these tools. Short intervals may be resource intensive, whereas long ones may not be suitable for early identification. Therefore, we aim to assess whether outcomes vary by measurement interval for 4 crowding estimation tools...
November 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27704323/comparison-of-emergency-department-crowding-scores-a-discrete-event-simulation-approach
#9
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
https://www.readbyqxmd.com/read/27331172/a-new-model-in-reducing-emergency-department-crowding-the-electronic-blockage-system
#10
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
https://www.readbyqxmd.com/read/26763939/the-impact-of-cognitive-stressors-in-the-emergency-department-on-physician-implicit-racial-bias
#11
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
https://www.readbyqxmd.com/read/26739294/comparison-of-the-international-crowding-measure-in-emergency-departments-icmed-and-the-national-emergency-department-overcrowding-score-nedocs-to-measure-emergency-department-crowding-pilot-study
#12
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
https://www.readbyqxmd.com/read/26594289/how-does-emergency-department-crowding-affect-medical-student-test-scores-and-clerkship-evaluations
#13
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
https://www.readbyqxmd.com/read/26495404/the-effect-of-emergency-department-overcrowding-on-efficiency-of-emergency-medicine-residents-education
#14
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)
https://www.readbyqxmd.com/read/26422432/overcrowding-and-clinical-risk-in-emergency-departments-a-model-for-the-reduction-in-nedocs-preliminary-results
#15
MULTICENTER STUDY
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...
September 14, 2015: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/25176566/the-inaccuracy-of-determining-overcrowding-status-by-using-the-national-ed-overcrowding-study-tool
#16
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
https://www.readbyqxmd.com/read/24411657/entropy-a-conceptual-approach-to-measuring-situation-level-workload-within-emergency-care-and-its-relationship-to-emergency-department-crowding
#17
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
https://www.readbyqxmd.com/read/23835266/measuring-emergency-department-crowding-in-an-inner-city-hospital-in-the-netherlands
#18
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
https://www.readbyqxmd.com/read/23786995/backboard-time-for-patients-receiving-spinal-immobilization-by-emergency-medical-services
#19
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)...
June 20, 2013: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/23663387/evaluation-of-ambulance-offload-delay-at-a-university-hospital-emergency-department
#20
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
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