The inaccuracy of determining overcrowding status by using the National ED Overcrowding Study Tool
| Autor: | Nestor R. Zenarosa, Noah White, Charles A. Huggins, Rani D Jayswal, Kellie Bunch, Hao Wang, Richard D. Robinson, Katherine Watson, Brett Banks |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Pediatrics Attitude of Health Personnel Emergency Nursing Tertiary Care Centers Hospitals Urban Health care Humans Medicine Prospective Studies business.industry Significant difference Emergency department overcrowding Reproducibility of Results General Medicine Emergency department Overcrowding Length of Stay Middle Aged Crowding Emergency medicine Emergency Medicine Female Observational study Emergency Service Hospital business Hospitals High-Volume Emergency nursing |
| Zdroj: | The American Journal of Emergency Medicine. 32:1230-1236 |
| ISSN: | 0735-6757 |
| DOI: | 10.1016/j.ajem.2014.07.032 |
| Popis: | 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. Material and methods This was a 2-phase study. In phase 1, ED crowding was determined by the NEDOCS tool. The ED length of stay and number of patients who left without being seen were analyzed. In phase 2, a survey of simulated ED census scenarios was completed by different providers. The interrater and intrarater agreements of ED crowding were tested. Results In phase 1, the subject ED was determined to be overcrowded more than 75% of the time in which nearly 50% was rated as severely overcrowded by the NEDOCS tool. No statistically significant difference was found in terms of the average length of stay and the number of left without being seen patients under different crowding categories. In phase 2, 88 surveys were completed. A moderate level of agreement between health care providers was reached ( κ = 0.5402, P r = 0.8833, P = .0007). The strength of agreement between study groups and the NEDOCS was weak ( κ = 0.3695, P Conclusion Using the NEDOCS tool to determine ED crowding might be inaccurate in an extremely high-volume ED setting. |
| Databáze: | OpenAIRE |
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