NEDOCS vs subjective evaluation, ¿Is the health personnel of the emergency department aware of its overcrowding?

https://doi.org/10.25100/cm.v48i2.2131

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Published: Jun 30, 2017
Issue: Vol. 48 No. 2 (2017)
Section Original Articles

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Authors

Mauricio García-Romero Fundación Cardiovascular de Colombia, Floridablanca, Colombia.
Claudia Geraldine Rita-Gáfaro Fundación Cardiovascular de Colombia, Floridablanca, Colombia.
Jairo Quintero-Manzano Fundación Cardiovascular de Colombia, Floridablanca, Colombia.
Anderson Bermon 1-Fundación Cardiovascular de Colombia, Floridablanca, Colombia. 2-Universidad CES, Medellín, Colombia.
Abstract
Introduction: An emergency department (ED) is considered to be "overcrowded" when the number of patients exceeds its treatment capacity and it does not have the conditions to meet the needs of the next patient to be treated. This study evaluates overcrowding in the emergency department of a hospital in Colombia.Objective: To compare the objective NEDOCS scale with a subjective evaluation by ED health staff in order to evaluate the differences between the two.Methods: The NEDOCS scale was applied and a subjective overcrowding survey was administered to the medical staff and the charge nurse on duty 6 times per day (6:00 a.m., 9:00 a.m., 12:00 p.m., 3:00 p.m., 6:00 p.m. and 9:00 p.m.) for three consecutive weeks. The results were evaluated with a correlation analysis and measurement of agreement.Results: A median NEDOCS score of 137 was obtained for the total data. There was a moderately positive correlation between the NEDOCS and the subjective scales, with a rho of 0.58 (p <0.001). During times when the ED was the most crowded, 87% of the total subjective health staff evaluations underestimated the level of overcrowding.Conclusions: Health staff do not perceive a risk due to ED overcrowding when the NEDOCS scores correspond to overcrowding categories equal to or over 5 (severely crowded and dangerously crowded), which poses a risk to patient safety and care.
Keywords
  • Emergency medical services
  • crowding
  • attitude of health personnel
  • surge capacity
  • social perception
  • health services needs and demands
Author Biographies

Mauricio García-Romero, Fundación Cardiovascular de Colombia, Floridablanca, Colombia.

Departamento de Urgencias, Fundación Cardiovascular de Colombia, Floridablanca, Colombia.

Claudia Geraldine Rita-Gáfaro, Fundación Cardiovascular de Colombia, Floridablanca, Colombia.

Departamento de Urgencias, Fundación Cardiovascular de Colombia, Floridablanca, Colombia.

Jairo Quintero-Manzano, Fundación Cardiovascular de Colombia, Floridablanca, Colombia.

Departamento de Urgencias, Fundación Cardiovascular de Colombia, Floridablanca, Colombia.

Anderson Bermon, 1-Fundación Cardiovascular de Colombia, Floridablanca, Colombia. 2-Universidad CES, Medellín, Colombia.

1  Centro de Investigaciones de la Fundación Cardiovascular de Colombia, Floridablanca, Colombia.

2 Estudiante PhD Epidemiología y Bioestadística, Universidad CES, Medellín, Colombia.

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How to Cite
García-Romero, M., Rita-Gáfaro, C. G., Quintero-Manzano, J., & Bermon, A. (2017). NEDOCS vs subjective evaluation, ¿Is the health personnel of the emergency department aware of its overcrowding?. Colombia Medica, 48(2), 53–57. https://doi.org/10.25100/cm.v48i2.2131
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