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. 2016 Feb 26;14(2):64-70.
doi: 10.5505/1304.7361.2014.13285. eCollection 2014 Jun.

A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System

Nese Colak Oray  1 , Sedat Yanturali  1 , Ridvan Atilla  1 , Gurkan Ersoy  1 , Hakan Topacoglu  2
Affiliations

A New Model in Reducing Emergency Department Crowding: The Electronic Blockage System

Nese Colak Oray et al. Turk J Emerg Med. .

Abstract
in English, Turkish

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.

Amaç: Acil servis kalabalığı tüm dünyada giderek yaygınlaşan bir sorundur. Hastanelerin acil servis kalabalık ölçütlerini kullanarak durum tespiti yapması ve uygun çözüm önerileri üretmeleri gereklidir.

Gereç ve yöntem: Çalışmamızda Hastane Bilgi Yönetim Sistemine ek bir program (Elektronik Blokaj Sistemi, EBS) yazıldı. Buna göre hastanede bulunan boş yatakların öncelikli olarak acil serviste yatış bekleyen hastalar için kullanılması planlandı. Acil serviste yatış bekleyen hasta varken, ilgili servislere yapılacak acil olmayan poliklinik yatışları bloke edildi. EBS başlamadan önceki dönem, EBS sonrası erken dönem ve EBS sonrası geç dönemde birer hafta boyunca NEDOCS skorlaması ile acil servis kalabalıklığı ölçüldü.

Bulgular: Elektronik blokaj sistemi sonrası erken dönemde diğer dönemlere göre NEDOCS değeri anlamlı olarak daha düşük bulundu (p≤0.0001). Her üç dönemde de acil servise başvuran günlük hasta sayısı ve ölçüm anında mevcut olan hasta sayısı değişmediği halde, acil servis içinde yatış bekleyen hasta sayısı EBS sonrası erken dönemde, EBS öncesi ve EBS sonrası geç döneme göre anlamlı olarak daha azdı (p=0.0001, p=0.001).

Sonuç: Elektronik blokaj sistemi, acil hastaların poliklinik hastalarına göre öncelikli olarak hastaneye yatışını sağlayan, kalabalığı önlemeye yönelik bir çeşit yatış triajı sistemidir. Hastanedeki toplam yatak sayısının yeterli olmadığı hastanelerde, acil servis kalabalığını azaltmak için acil servisten hastaneye olan yatışları hızlandırmak amacıyla kullanılabilir.

Keywords: Emergency department; NEDOCS; National Emergency Department Overcrowding Study; overcrowding.

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Figures

Figure 1
Figure 1
NEDOCS Values by Periods.
See this image and copyright information in PMC

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