Emergency Department Overcrowding Clinical Trial
Official title:
A Validation Study of Emergency Department Crowding Estimation
The aim of this study is to externally validate a new emergency department overcrowding estimation tool (SONET) developed at John Peter Smith Health Network (JPS).
In recent years, emergency department (ED) overcrowding has become more and more common in
regional and tertiary referral hospitals. ED overcrowding status significantly affects ED
operational efficiency, resulting in ambulance diversion, increased ED 72h return visits,
patient satisfaction, and left without being seen (LWBS) rates.
Several estimation tools were derived to determine ED overcrowding status using various
operational parameters such as, but not limited to, total number of ED patients, total ED
admission holds, nursing staff, and patient injury severity. However, these tools cannot
precisely evaluate ED overcrowding status, nor show strong correlations with ED operational
inefficiency. The National Emergency Department Overcrowding Study (NEDOCS) is a widely used
estimation tool to determine ED overcrowding status with relatively high consistency rates.
However, the study was not able to evaluate interrater reliability since no standard
definition of overcrowding existed.
An ED overcrowding estimation tool, SONET, was developed and internally validated at JPS and
showed more consistency and accuracy when compared to estimation rates utilizing NEDOCS. All
things considered, it is worthwhile to perform a survey study to determine the interrater
variability between different evaluators for an ED overcrowding evaluation tool, one
utilizing all possible collectible operational variables. In order to minimize the bias and
further determine the accuracy of evaluating ED overcrowding status, a multi-center external
validation study is warranted. This study will extend to six sites for the purpose of
externally validating JPS' novel ED overcrowding estimation tool, SONET, by comparing its
overcrowding estimation rates with those derived utilizing NEDOCS.
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