Evaluation of Overcrowding of Emergency Department in Imam Reza Hospital in 2015 by Implementing 2 Scales: NEDOCS and EDWIN

Abstract

Background: The reason behind patients' overcrowding in emergency departments (ED) maybe due to several factors such as great number of referring patients or inaccessibility of facilities or hospital beds. Objectives: The present study aimed at evaluating the overcrowding of ED in Tabriz Imam Reza hospital in 2015 using 2 scales: National Emergency Overcrowding Scale (NEDOCS), and Emergency Department Work Index (EDWIN). Methods: This was a cross-sectional descriptive study conducted in the ED of Imam Reza hospital affiliated to Tabriz University of Medical Sciences, Iran, in a one-year period (Jan-Dec 2015). Convenience sampling method was used for data collection. During the study, the researchers randomly selected 10 days out of every month and started to collect index variables 4 times a day at 6 AM, 12 noon, 6 PM, and 12midnight. In total, 488 samples were gathered and both NEDOCS and EDWIN were implemented for each sample. Then, the frequency of overcrowding in the emergency department was reported based on the obtained results. Results: Based on NEDOCS, ED was extremely busy, but not overcrowded in 51 cases (10.5%), it was overcrowded in 298 (61.1%) cases, severely overcrowded in 138 cases (28.3%), and it was busy only in one case (0.2%). However, based on the EDWIN scale, the ED was active but manageable in 91 cases (18.6%), very busy in 36 cases (7.4%), and extremely busy in the remaining 361 cases (74%). Conclusions: EDWIN scale depicted August, July, December, June, and April to be, respectively, the most overcrowded months. This finding revealed EDWIN scale to perform better when trying to have an overall assessment of ED during the whole year, which helps us have clear-cut results for analysis and policy making in managing EDs.