NEDOCS.org

NEDOCS National Emergency Department Overcrowding Score is an objective measure of hospital crowding. The National Emergency Department Overcrowding Scale is calculated using values that are common to all hospitals. This NEDOCS wiki holds synthesized patient flow, hospital crowding and NEDOCS information. Please visit NEDOCS.org for a starting point on NEDOCS for hospitals.

Equation/Formula

The score based on the NEDOCS equation above can fall into various levels on a scale, providing an objective estimation of the degree of crowdedness in the ED and the medical center.

This formula will provide a snapshot of the NEDOCS score at the time it was calculated. The score can fall on a scale you choose to develop based on studies at your facility.

Variables and Constants

Total Patients - The number of total patients in the ED at the time the score is calculated. This includes all patients in all areas including waiting patients, Fast Track patients, etc.

ED Beds - The total number of ED beds including hallways, chairs, fast track and other beds that can be used to serve patients at the time the score is calculated.

Admits - The number of holdovers/admits, in the ED, at the time the score is calculated.

Hospital Beds - The total number of hospital beds. Most implementations use the number of licensed beds that can be used in case of a disaster.

Ventilators - The number of patients on ventilators/respirators in the ED at the time the score is calculated.

Longest Admit - The longest admit holdover/boarding (in hours) at the time the score was calculated (For eg. 3.5 = 3 hours 30 minutes).

Last Bed Time - The wait time (in hours) from arrival to bed for the last patient called for a bed (For eg. 1.33 = 1 hour and 20 minutes).

Scale

The original NEDOCS (study) shows six levels, as does the University of New Mexico's NEDOCS calculator.

The above scale reflected accurate perception of levels of overcrowdedness at USC. The University of New Mexico's calculator shows six different levels. The NEDOCS study also used six levels.

Based on these levels USC has developed a surge plan that proved dramatic decompression of the ED in short periods of time.

An objective measure of overcrowdedness can be a key to solving patient flow problems at hospitals accross the world.