Empiric Study of Real-time ED Crowding Surveillance System

• Main Authors: Lee Wei-Che, 李維哲
• Other Authors: King-Teh Lee
• Format: Others
• Language: zh-TW
• Published: 2012
• Online Access: http://ndltd.ncl.edu.tw/handle/92169089334358633379

碩士 === 高雄醫學大學 === 醫務管理學研究所碩士在職專班 === 100 === Background: Emergency Department (ED) crowding is a global problem with increasing intensity in Taiwan. However, there is no universal definition or criteria about crowding, and real-time surveillance system is also absent. Therefore, it is difficult in forming the strategy of solution or even responding to this problem. Throughout a real-time collecting and analyzing program of the crowding-related data, the purpose of the study is to verify six commonly-used ED crowding index by the official databank, the Emergency Medical Operation Center（EMOC）crowding announcement records, and looks for the most effective ones in monitoring ED crowding of the target ED. The study also aims on developing a real-time surveillance system for the target ED for more effective crowding monitoring, and hopefully that it can also be used in other hospital. With district-wide employment of this real-time surveillance system in most hospital, the information can provide a more efficient utilization of the emergency medical system and helps to save life and resources. Method: The related data from target ED was collected automatically in a 10-minute period from the Hospital information System（HIS）and transformed into 6 ED crowding indices. These indices were then correlated with the official crowding records of the EMOC and their sensitivity and specificity in relationship to occurrence of crowding was marked. Then we use the Receiver Operating Characteristic (ROC) Curve analysis to identify the most useful indices. Results: EDWIN、Work score、Occupancy Level have the highest interpretative ability to the target ED. After general consideration, EDWIN may be used as the main index in building the real-time surveillance system for the target ED, assisting by Occupancy level and Work score for more accuracy. The cut-off value for each index are: EDWIN 0.884259259259259,Work score 11.106, and Occupancy Level 0.865546218487395. Conclusion: The commonly-used ED crowding indices can be used to monitor the occurrence of crowding in target ED and build up a real-time surveillance system for the target ED.