Comparison of emergency department crowding scores: a discrete-event simulation approach

Virginia Ahalt, Nilay Tanık Argon (), Serhan Ziya, Jeff Strickler and Abhi Mehrotra
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Virginia Ahalt: University of North Carolina
Nilay Tanık Argon: University of North Carolina
Serhan Ziya: University of North Carolina
Jeff Strickler: University of North Carolina School of Medicine
Abhi Mehrotra: University of North Carolina School of Medicine

Health Care Management Science, 2018, vol. 21, issue 1, No 10, 144-155

Abstract: Abstract According to American College of Emergency Physicians, emergency department (ED) crowding occurs when the identified need for emergency services exceeds available resources for patient care in the ED, hospital, or both. ED crowding is a widely reported problem and several crowding scores are proposed to quantify crowding using hospital and patient data as inputs for assisting healthcare professionals in anticipating imminent crowding problems. Using data from a large academic hospital in North Carolina, we evaluate three crowding scores, namely, EDWIN, NEDOCS, and READI by assessing strengths and weaknesses of each score, particularly their predictive power. We perform these evaluations by first building a discrete-event simulation model of the ED, validating the results of the simulation model against observations at the ED under consideration, and utilizing the model results to investigate each of the three ED crowding scores under normal operating conditions and under two simulated outbreak scenarios in the ED. We conclude that, for this hospital, both EDWIN and NEDOCS prove to be helpful measures of current ED crowdedness, and both scores demonstrate the ability to anticipate impending crowdedness. Utilizing both EDWIN and NEDOCS scores in combination with the threshold values proposed in this work could provide a real-time alert for clinicians to anticipate impending crowding, which could lead to better preparation and eventually better patient care outcomes.

Keywords: Emergency department crowding; Discrete-event simulation; Queueing model; Edwin; NEDOCS; READI (search for similar items in EconPapers)
Date: 2018
References: View complete reference list from CitEc
Citations: View citations in EconPapers (8)

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DOI: 10.1007/s10729-016-9385-z

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