Measuring the crowding of emergency departments: an assessment of the NEDOCS in Lombardy, Italy, and the development of a new objective indicator based on the waiting time for the first clinical assessment

Measuring the crowding of emergency departments: an assessment of the NEDOCS in Lombardy, Italy, and the development of a new objective indicator based on the waiting time for the first clinical assessment

There is no ubiquitous definition of Emergency Department (ED) crowding and several indicators have been proposed to measure it. The National ED Overcrowding Study (NEDOCS) score is among the most popular, even though it has been severely criticised. We used the waiting time for the physician’s initial assessment to evaluate the performance of the NEDOCS and proposed a new crowding indicator based on this objective measure.

Patients’ waiting time did not increase at the increase of the NEDOCS score, suggesting the absence of a relationship between this score and the effect of ED crowding on the ED capacity of evaluating new patients. The indicator we propose is easy to estimate in real-time and based on centre-specific cutoffs, which depend on the volume of yearly accesses. We observed minimal agreement between the proposed indicator and the NEDOCS in most EDs, both in the development and validation datasets.

Fabiola Signorini, Giovanni Nattino, Carlotta Rossi, Walter Ageno, Felice Catania, Francesca Cortellaro, Giorgio Costantino, Andrea Duca, Giulia Irene Ghilardi, Stefano Paglia, Paolo Pausilli, Cristiano Perani, Giuseppe Sechi & Guido Bertolini

https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01112-9

BMC Emergency Medicine

17 oktober 2024

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