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Effect of access block on emergency department crowding calculated by NEDOCS score

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dc.contributor.authorALTUN, MUSTAFA
dc.contributor.authorKARACABEY, SİNAN
dc.contributor.authorSANRI, ERKMAN
dc.contributor.authorONUR, ÖZGE ECMEL
dc.contributor.authorDENİZBAŞI ALTINOK, ARZU
dc.contributor.authorAKOĞLU, HALDUN
dc.contributor.authorsAltun M., Kudu E., Demir O., KARACABEY S., SANRI E., ONUR Ö. E., DENİZBAŞI ALTINOK A., AKOĞLU H.
dc.date.accessioned2024-08-12T08:10:37Z
dc.date.available2024-08-12T08:10:37Z
dc.date.issued2024-08-01
dc.description.abstractObjective: Emergency department (ED) crowding poses a significant challenge in healthcare systems globally, leading to delays in patient care and threatening public health and staff well-being. Access block, characterized by delays in admitting patients awaiting hospitalization, is a primary contributor to ED overcrowding. To address this issue, the National Emergency Department Overcrowding Study (NEDOCS) score provides an objective framework for assessing ED crowding severity. This study aims to evaluate the impact of access block on ED crowding using the NEDOCS score and to explore strategies for mitigating overcrowding through scenarios over a 39-day period. Methods: A single-center, prospective, observational study was conducted in an urban tertiary care referral center. The NEDOCS score was collected six times daily, including variables like total ED patients, ventilated patients, boarding patients, the longest waiting times, and durations of boarding patients. NEDOCS scores were recorded, and calculations were performed to assess the potential impact of eliminating access block in scenarios. Results: NEDOCS scores ranged from 62.4 to 315, with a mean of 146, indicating consistent overcrowding. Analysis categorized ED conditions into different levels, revealing that over 81.2% of the time, the ED was at least overcrowded. The longest boarding patient\"s waiting duration was identified as the primary contributor to NEDOCS (48.8%). Scenarios demonstrated a significant decrease in NEDOCS when access block was eliminated through timely admissions. Shorter boarding times during non-working hours suggest the potential mitigating effect of external factors on the access barrier. Additionally, daytime measurements were associated with lower patient admissions and shorter wait times for initial assessment. Conclusion: Although ED crowding is a multifactorial problem, our study has shown that access block contribute significantly to this problem. The study emphasizes that eliminating access block through timely admissions could substantially alleviate crowding, highlighting the importance of addressing this issue to enhance ED efficiency and overall healthcare delivery.
dc.identifier.citationAltun M., Kudu E., Demir O., KARACABEY S., SANRI E., ONUR Ö. E., DENİZBAŞI ALTINOK A., AKOĞLU H., "Effect of access block on emergency department crowding calculated by NEDOCS score", American Journal of Emergency Medicine, cilt.82, ss.136-141, 2024
dc.identifier.doi10.1016/j.ajem.2024.06.016
dc.identifier.endpage141
dc.identifier.issn0735-6757
dc.identifier.startpage136
dc.identifier.urihttps://www.sciencedirect.com/science/article/pii/S0735675724002833?via%3Dihub
dc.identifier.urihttps://hdl.handle.net/11424/297532
dc.identifier.volume82
dc.language.isoeng
dc.relation.ispartofAmerican Journal of Emergency Medicine
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectTıp
dc.subjectCerrahi Tıp Bilimleri
dc.subjectAcil Tıp
dc.subjectSağlık Bilimleri
dc.subjectMedicine
dc.subjectSurgery Medicine Sciences
dc.subjectEmergency Medicine
dc.subjectHealth Sciences
dc.subjectKlinik Tıp (MED)
dc.subjectKlinik Tıp
dc.subjectACİL TIP
dc.subjectClinical Medicine (MED)
dc.subjectCLINICAL MEDICINE
dc.subjectEMERGENCY MEDICINE
dc.subjectAccess block
dc.subjectBoarding patients
dc.subjectEmergency department overcrowding
dc.subjectNEDOCS
dc.titleEffect of access block on emergency department crowding calculated by NEDOCS score
dc.typearticle
dspace.entity.typePublication
local.avesis.id0c3f800d-ba40-4ecb-80dc-b7ad3ba38304
local.indexed.atPUBMED
local.indexed.atSCOPUS
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relation.isAuthorOfPublication.latestForDiscovery310e683d-8187-4504-b0a1-db11fbda7bad

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