| Popis: |
Summary Objective: To assess the relevance of real-time bed occupancy rate (RTO) to the evaluation of a medical emergency unit. Methods : The number of patients present in the emergency unit (EU) and in the observation ward (OW) at five given times of the day or night (0:00, 6:00, 13:00, 18:00, 21:00) was recorded daily over a 4-year period (1992–1995) and related to the unit and ward capacities (EU=14 beds, OW=10 beds). This permitted identifying daily overcrowding duration periods according to the days of the week and computing cumulative overcrowding duration per week, month, year and for 1994. The results were correlated to epidemiological data. Results: The ermergency unit was continually overcrowded, depending on the days of the week, from 13:00 to 18:00, 18:00 to 21:00 or 21:00 to 00:00, with a higher number of patients over capacity on the first three days of the week and in winter. Monthly overcrowding varied from 30 to 40% over the four experimental years. No correlation was found between the number of patients over capacity (overcrowding index) and epidemiological data, such as the overall number of admissions to the hospital in particular. The vanations in overcrowding duration were directly linked to the availability of beds in the wards where patients were to be dispatched afterwards. The same real-time recording in the OW elicited identical and parallel variations in patient fluxes over the experimental periods. Conclusion: RTO objectively and quantitatively demonstrated the inadequacies of our EU and provided objective data on the management of our OW. This method is simple, reproducible and valuably contributes to the preparation of topographic rearrangement and personnel distribution of the EU according to operational fluctuations. It also reflects the accomodation capacities downstream of the EU. |
