ED Overcrowding Validation Study

NCT ID: NCT02754245

Last Updated: 2017-06-07

Basic Information

• Recruitment Status: UNKNOWN
• Total Enrollment: 55000 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2016-11-14
• Study Completion Date: 2017-07-31

Brief Summary

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).

Detailed Description

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.

Conditions

Emergency Department Overcrowding

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

JPS

study sample at JPS included for analysis

No interventions assigned to this group

BUMC Dallas

study sample at Baylor University Medical Center Dallas included for analysis

No interventions assigned to this group

BUMC at Gardin

study sample at Baylor University Medical Center Gardin included for analysis

No interventions assigned to this group

BUMC Waxahachie

study sample at Baylor University Medical Center Waxahachie included for analysis

No interventions assigned to this group

BUMC Carrolton

study sample at Baylor University Medical Center Carrolton included for analysis

No interventions assigned to this group

BUMC McKinney

study sample at Baylor University Medical Center McKinney included for analysis

No interventions assigned to this group

Eligibility Criteria

Inclusion Criteria

• 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

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 100 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

JPS Health Network

OTHER

Sponsor Role: collaborator

Baylor University

OTHER

Sponsor Role: collaborator

Baylor Research Institute

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

References

Bernstein SL, Verghese V, Leung W, Lunney AT, Perez I. Development and validation of a new index to measure emergency department crowding. Acad Emerg Med. 2003 Sep;10(9):938-42. doi: 10.1111/j.1553-2712.2003.tb00647.x.

Reference Type: BACKGROUND

PMID: 12957975 (View on PubMed)

Weiss SJ, Derlet R, Arndahl J, Ernst AA, Richards J, Fernandez-Frackelton M, Schwab R, Stair TO, Vicellio P, Levy D, Brautigan M, Johnson A, Nick TG. Estimating the degree of emergency department overcrowding in academic medical centers: results of the National ED Overcrowding Study (NEDOCS). Acad Emerg Med. 2004 Jan;11(1):38-50. doi: 10.1197/j.aem.2003.07.017.

Reference Type: BACKGROUND

PMID: 14709427 (View on PubMed)

Epstein SK, Tian L. Development of an emergency department work score to predict ambulance diversion. Acad Emerg Med. 2006 Apr;13(4):421-6. doi: 10.1197/j.aem.2005.11.081.

Reference Type: BACKGROUND

PMID: 16581932 (View on PubMed)

McCarthy ML, Aronsky D, Jones ID, Miner JR, Band RA, Baren JM, Desmond JS, Baumlin KM, Ding R, Shesser R. The emergency department occupancy rate: a simple measure of emergency department crowding? Ann Emerg Med. 2008 Jan;51(1):15-24, 24.e1-2. doi: 10.1016/j.annemergmed.2007.09.003. Epub 2007 Nov 5.

Reference Type: BACKGROUND

PMID: 17980458 (View on PubMed)

Jones SS, Allen TL, Flottemesch TJ, Welch SJ. An independent evaluation of four quantitative emergency department crowding scales. Acad Emerg Med. 2006 Nov;13(11):1204-11. doi: 10.1197/j.aem.2006.05.021. Epub 2006 Aug 10.

Reference Type: BACKGROUND

PMID: 16902050 (View on PubMed)

Wang H, Robinson RD, Garrett JS, Bunch K, Huggins CA, Watson K, Daniels J, Banks B, D'Etienne JP, Zenarosa NR. Use of the SONET Score to Evaluate High Volume Emergency Department Overcrowding: A Prospective Derivation and Validation Study. Emerg Med Int. 2015;2015:401757. doi: 10.1155/2015/401757. Epub 2015 Jun 8.

Reference Type: BACKGROUND

PMID: 26167302 (View on PubMed)

Other Identifiers

014-013

Identifier Type: -

Identifier Source: org_study_id