A Validation Study of Emergency Department Crowding Estimation
概览
- 阶段
- 不适用
- 干预措施
- BUMC Waxahachie
- 疾病 / 适应症
- Emergency Department Overcrowding
- 发起方
- Baylor Research Institute
- 入组人数
- 7000
- 主要终点
- hospital mortality
- 状态
- 终止
- 最后更新
- 2个月前
概览
简要总结
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).
详细描述
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.
研究者
入排标准
入选标准
- •all adult patients visiting the emergency department or urgent care clinic at any one of the six participating sites during the allocated one month time period
排除标准
- •those who do not meet inclusion criteria
研究组 & 干预措施
BUMC Waxahachie
study sample at Baylor University Medical Center Waxahachie included for analysis
BUMC Carrolton
study sample at Baylor University Medical Center Carrolton included for analysis
BUMC McKinney
study sample at Baylor University Medical Center McKinney included for analysis
JPS
study sample at JPS included for analysis
BUMC Dallas
study sample at Baylor University Medical Center Dallas included for analysis
BUMC at Gardin
study sample at Baylor University Medical Center Gardin included for analysis
结局指标
主要结局
hospital mortality
时间窗: 30 days
emergency department length of stay
时间窗: 30 days
left without being seen disposition chart review
时间窗: 30 days
LWBS refers to patients who have been called at least three times, using 20 minute intervals, to occupy an ED exam bed, however, do not respond. If after the third attempt the patient responds, the investigators will consider this a new patient registration/encounter. These data will be collected for each patient during the study period during initial ED registration and upon ED disposition.
emergency department 72 hour return chart review
时间窗: 30 days
ED 72h return will be defined to patients who re-register to the same ED as a new patient (unplanned) within 72h of a previous departure, regardless of the complaint. Planned ED revisits within 72h will be excluded. These data will be collected during initial ED registration during study period and will follow up each patient at least 72h post-discharge.
emergency department mortality
时间窗: 30 days
次要结局
- patient satisfaction survey(30 days)
- physician empathy scale(30 days)