An Effective Methodology for Scoring to Assist Emergency Physicians in Identifying Overcrowding in an Academic Emergency Department in Thailand
Emergency Department (ED) overcrowding is recognized worldwide, with several tools like NEDOCS, READI, and Work Score employed to predict and manage the issue. Despite their utility, there's no universally accepted definition or method to measure ED overcrowding. This limitation is exacerbated by the geographic specificity of most studies and the impracticality of the complex scoring systems for developing countries.
This study aimed to assess the effectiveness of existing overcrowding scores (EDWIN, occupancy rate, Work Score) and a modified EDWIN version introduced by the researchers. It focused on how these scores correlate with emergency physicians' real-time assessments of overcrowding and their relationship with adverse events during ED code activations.
Through a correlational study analyzing 459 periods, it was found that the Emergency Department Overcrowding Rate (EDOR) had the highest correlation with physicians' perceptions of overcrowding and was the only score significantly linked to adverse events. The study concludes that EDOR is most aligned with emergency physicians' views on overcrowding and suggests that these perceptions may indicate the potential for adverse events. Despite the challenges in measuring overcrowding, the study highlights the importance of such scores for predicting and potentially preventing negative outcomes in EDs.
