ArticleBMC nursing2026
Census rate as a pragmatic indicator of emergency department crowding: a multicentre prospective observational comparison with CEDOCS against frontline-perceived workload.
Article in BMC nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergency department (ED) crowding affects patient flow, care timeliness, staff well-being, and frontline workload. Although several crowding metrics are available, their interpretability across EDs of different sizes remains uncertain. We compared Census Rate (CR) and the Community Emergency Department Overcrowding Scale (CEDOCS) against frontline-perceived workload across three French EDs.
methodsWe conducted a multicentre prospective observational study from 15 to 28 May 2023 in one university hospital and two community hospitals. Twice daily, operational variables were recorded and eligible frontline staff completed a 6-point staff workload assessment (SWA). The primary outcome was the association between SWA and each crowding metric. Spearman's rank correlation was prespecified as the primary analysis, with Pearson correlations and linear regression as sensitivity analyses. Overlapping dependent correlations were compared using Williams' test. Additional exploratory analyses examined empirical CR tertiles.
resultsEighty-four site-time observations were expected, of which 81 had complete data for the main analyses. CR showed a strong association with SWA (Spearman's ρ = 0.744, 95% CI 0.619 to 0.832; p < 0.001), whereas the association for CEDOCS was more moderate (ρ = 0.471, 95% CI 0.289 to 0.616; p < 0.001). The association between CR and SWA was significantly stronger than that between CEDOCS and SWA (difference in correlations 0.273, 95% CI 0.116 to 0.438; Williams' t = 4.728, df = 78; p < 0.001). In community hospitals, both metrics performed similarly, whereas CR showed a clearer advantage overall. Empirical CR tertiles were significantly associated with SWA and were used for exploratory interpretation within this dataset.
conclusionsAcross EDs of different sizes, CR showed a stronger association with frontline-perceived workload than CEDOCS. These findings suggest the potential value of CR as a simple and interpretable crowding metric to support shared situational awareness and workload-informed discussions, pending validation in broader settings and nurse-specific studies.
Indexed as
Identifiers
What OpenQuestion holds
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.