Sharma Raman, Prakash Ajay, Chauhan Rajeev, Dhibar Deba Prasad
Department of Hospital Administration, PGIMER, Chandigarh, India.
Department of Pharmacology, PGIMER, Chandigarh, India.
J Educ Health Promot. 2021 Jan 28;10:5. doi: 10.4103/jehp.jehp_289_20. eCollection 2021.
Emergency department (ED) overcrowding is one of the leading problems of health-care organizations, discerned by ED medical staff, but it has never been measured objectively.
A 2 months prospective cross-sectional study was conducted to compare ED overcrowding measurement tools with the perceptions of ED emergency physician and ED assistant nursing superintendent (EDEP/EDANS).
The results have shown that perceptions of ED overcrowding as noted by EDEP and EDANS, taken on a Likert scale, were 83.34% and 86.67%, respectively. Kappa values show a significant agreement between EDEP and EDANS subjective perceptions with objective values of the National Emergency Department Overcrowding Study (NEDOCS), Real-time Emergency Analysis of Demand Indicators (READI), and Emergency Department Work Index (EDWIN) scales. Furthermore, all three scales have statistically significant correlation; NEDOCS and READI had highest level of correlation coefficient ( = 0.662, < 0.01) whereas READI and EDWIN shows least correlation coefficient value ( = 0.155, < 0.01).
Therefore, these scales may serve to quantify the subjective impressions of ED overcrowding. Evidence is clear of overcrowding harms, measures are needed to provide urgent medical care and future work up is need of the hour to systematically evaluate interventions and guide evidence-based policies.
急诊科过度拥挤是医疗机构面临的主要问题之一，急诊科医务人员能够察觉到这一问题，但此前从未进行过客观衡量。
开展一项为期2个月的前瞻性横断面研究，以比较急诊科过度拥挤测量工具与急诊科急诊医师和急诊科助理护士长（EDEP/EDANS）的认知情况。
结果显示，EDEP和EDANS对急诊科过度拥挤的认知情况（采用李克特量表）分别为83.34%和86.67%。卡帕值表明，EDEP和EDANS的主观认知与国家急诊科过度拥挤研究（NEDOCS）、需求指标实时应急分析（READI）和急诊科工作指数（EDWIN）量表的客观值之间存在显著一致性。此外，所有三个量表均具有统计学显著相关性；NEDOCS和READI的相关系数水平最高（=0.662，<0.01），而READI和EDWIN的相关系数值最低（=0.155，<0.01）。
因此，这些量表可用于量化急诊科过度拥挤的主观印象。过度拥挤危害的证据确凿，需要采取措施提供紧急医疗护理，当前亟需开展进一步工作，以系统评估干预措施并指导循证政策。
