ArticleAnnals of emergency medicine2007
Measuring and forecasting emergency department crowding in real time.
Article in Annals of emergency medicine, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 44 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
44 citing papers in PubMed.
- Emergency Department Overcrowding Despite Lower Post-Pandemic Volumes: A Multicenter Study.Journal of clinical medicine · 2026Article
- Daily emergency department volume and in-hospital mortality: the importance of temporal alignment.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Crowding in real-time: an artificial intelligence-based model to manage crowding in the emergency department (CRAMMED Study).BMC emergency medicine · 2026Article
- Development and validation of a multivariable predictive model for Emergency Department Overcrowding based on the National Emergency Department Overcrowding Study (NEDOCS) score.Internal and emergency medicine · 2025Article
- Emergency Department Boarding, Crowding, and Error.Journal of the American College of Emergency Physicians open · 2025Article
- Managing low-acuity patients in an Emergency Department through simulation-based multiobjective optimization using a neural network metamodel.Health care management science · 2024Article
- An Effective Methodology for Scoring to Assist Emergency Physicians in Identifying Overcrowding in an Academic Emergency Department in Thailand.BMC medical informatics and decision making · 2024Article
- Emergency department overcrowding and its associated factors at HARME medical emergency center in Eastern Ethiopia.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2024Article
- Time-series Machine Learning Models to Support Emergency Department Operational Planning.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2024Article
- Five Level Triage vs. Four Level Triage in a Quaternary Emergency Department: National Analysis on Waiting Time, Validity, and Crowding-The CREONTE (Crowding and RE-Organization National TriagE) Study Group.Medicina (Kaunas, Lithuania) · 2023Article
- Ochsner Emergency Department Overcrowding Scale (OEDOCS): predicting Emergency Department crowding among diverse academic hospital settings.AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science · 2023Article
- Differentiating properties of occupancy rate and workload to estimate crowding: A Swedish national cross-sectional study.Journal of the American College of Emergency Physicians open · 2022Article
- Measures of Emergency Department Crowding, a Systematic Review. How to Make Sense of a Long List.Open access emergency medicine : OAEM · 2022Review
- How New Mexico Leveraged a COVID-19 Case Forecasting Model to Preemptively Address the Health Care Needs of the State: Quantitative Analysis.JMIR public health and surveillance · 2021Article
- Validation of the modified Skåne emergency department assessment of patient load (mSEAL) model for emergency department crowding and comparison with international models; an observational study.BMC emergency medicine · 2021Observational
- Does crowding influence emergency department treatment time and disposition?Journal of the American College of Emergency Physicians open · 2021Article
- Overcrowding an encumbrance for an emergency health-care system: A perspective of Health-care providers from tertiary care center in Northern India.Journal of education and health promotion · 2021Article
- Theoretical bounds and approximation of the probability mass function of future hospital bed demand.Health care management science · 2020Article
- Ambulance diversions following public hospital emergency department closures.Health services research · 2019Article
- Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
4 authors.
Funding
Abstract
STUDY
objectiveWe quantified the potential for monitoring current and near-future emergency department (ED) crowding by using 4 measures: the Emergency Department Work Index (EDWIN), the National Emergency Department Overcrowding Scale (NEDOCS), the Demand Value of the Real-time Emergency Analysis of Demand Indicators (READI), and the Work Score.
methodsWe calculated the 4 measures at 10-minute intervals during an 8-week study period (June 21, 2006, to August 16, 2006). Ambulance diversion status was the outcome variable for crowding, and occupancy level was the performance baseline measure. We evaluated discriminatory power for current crowding by the area under the receiver operating characteristic curve (AUC). To assess forecasting power, we applied activity monitoring operating characteristic curves, which measure the timeliness of early warnings at various false alarm rates.
resultsWe recorded 7,948 observations during the study period. The ED was on ambulance diversion during 30% of the observations. The AUC was 0.81 for the EDWIN, 0.88 for the NEDOCS, 0.65 for the READI Demand Value, 0.90 for the Work Score, and 0.90 for occupancy level. In the activity monitoring operating characteristic analysis, only the occupancy level provided more than an hour of advance warning (median 1 hour 7 minutes) before crowding, with 1 false alarm per week.
conclusionThe EDWIN, the NEDOCS, and the Work Score monitor current ED crowding with high discriminatory power, although none of them exceeded the performance of occupancy level across the range of operating points. None of the measures provided substantial advance warning before crowding at low rates of false alarms.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.