Document Detail

The emergency department occupancy rate: a simple measure of emergency department crowding?
MedLine Citation:
PMID:  17980458     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVE: We examine the validity of the emergency department (ED) occupancy rate as a measure of crowding by comparing it to the Emergency Department Work Index Score (EDWIN), a previously validated scale. METHODS: A multicenter validation study was conducted according to ED visit data from 6 academic EDs for a 3-month period in 2005. Hourly ED occupancy rate (ie, total number of patients in ED divided by total number of licensed beds) and EDWIN scores were calculated. The correlation between the scales was determined and their validity evaluated by their ability to discriminate between hours when 1 or more patients left without being seen and hours when the ED was on ambulance diversion, using area under the curve (AUC) statistics estimated from the bootstrap method. RESULTS: We calculated the ED occupancy rate and EDWIN for 2,208 consecutive hours at each of the 6 EDs. The overall correlation between the 2 scales was 0.58 (95% confidence interval [CI] 0.56 to 0.60). The ED occupancy rate (AUC=0.73; 95% CI 0.65 to 0.80) and the EDWIN (AUC=0.65; 95% CI 0.58 to 0.72) did not differ significantly in correctly identifying hours when patients left without being seen. The ED occupancy rate (AUC=0.78; 95% CI 0.75 to 0.80) and the EDWIN (AUC=0.70; 95% CI 0.59 to 0.81) performed similarly for ED diversion hours. CONCLUSION: The ED occupancy rate and the EDWIN classified leaving without being seen and ambulance diversion hours with moderate accuracy. Although the ED occupancy rate is not ideal, its simplicity makes real-time assessment of crowding feasible for more EDs nationwide.
Melissa L McCarthy; Dominik Aronsky; Ian D Jones; James R Miner; Roger A Band; Jill M Baren; Jeffrey S Desmond; Kevin M Baumlin; Ru Ding; Robert Shesser
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Validation Studies     Date:  2007-11-05
Journal Detail:
Title:  Annals of emergency medicine     Volume:  51     ISSN:  1097-6760     ISO Abbreviation:  Ann Emerg Med     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-01     Completed Date:  2008-01-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  15-24, 24.e1-2     Citation Subset:  AIM; IM    
Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21209, USA.
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MeSH Terms
Bed Occupancy / statistics & numerical data*
Discriminant Analysis
Emergency Service, Hospital / statistics & numerical data*,  utilization
Patient Admission / statistics & numerical data
Patient Transfer / statistics & numerical data
Grant Support
R21 LM 009002-02/LM/NLM NIH HHS

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