A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System
Nese COLAK ORAY1, Sedat YANTURALI1, Ridvan ATILLA1, Gurkan ERSOY1, Hakan TOPACOGLU2
1Department of Emergency Medicine, Dokuz Eylul University Faculty of Medicine, Izmir
2Department of Clinic of Emergency, İstanbul Training and Research Hospital, Istanbul
Keywords: Emergency department; National Emergency Department Overcrowding Study; NEDOCS; overcrowding
Abstract
Objectives
Emergency department (ED) crowding is a growing problem across the world. Hospitals need to identify the situation using emergency department crowding scoring systems and to produce appropriate solutions.
Methods
A new program (Electronic Blockage System, EBS) was written supplementary to the Hospital Information System. It was planned that the number of empty beds in the hospital should primarily be used for patients awaiting admission to a hospital bed at the ED. In the presence of patients awaiting admission at the ED, non-urgent admissions to other departments were blocked. ED overcrowded was measured in the period before initiation of EBS, the early post-EBS period and the late post-EBS period, of one-week's duration each, using NEDOCS scoring.
Results
NEDOCS values were significantly lower in the early post-EBS period compared to the other periods (p≤0.0001). Although outpatient numbers applying to the ED and existing patient numbers at time of measurement remained unchanged in all three periods, the number of patients awaiting admission in the early post-EBS period was significantly lower than in the pre-EBS and late post-EBS periods (p=0.0001, p=0.001).
Conclusions
EBS is a form of triage system aimed at preventing crowding and ensuring the priority admission of emergency patients over that of polyclinic patients. In hospitals with an insufficient number of total beds it can be used to reduce ED crowding and accelerate admissions to hospital from the ED.