Research And Application Of Emergency Department Overcrowding Scale Tool

[Objective]Using input-throughout-output as conceptual model, the standard procedure ofcross-culture adaptation was used to develop the National Emergency DepartmentOvercrowding Scale made by USA. And researcher modified the items of the tool, toform Modified Emergency Department Crowding Scale tool which was suitable forChina. Then test its reliability and validity, aiming to provide a reference basis for theemergency management at all levels to accurately assess and predict the emergencycrowded degree and formulate preventions and interventions.[Methods]1. The linguistic translation of the National Emergency Department OvercrowdingScale was performed following the standard process of "Translation-Backtranslation-Cultural Adjustment-Preliminary Test-Field Test", and modified throughsemi-structured interview and trial test.2. Researcher and her companion conduct a survey on the emergency visitingregularity from March1,2012to March31,2012of a3A grade hospital in Shanghaiby sampling conveniently. The collected data were analyzed to reevaluate thereliability and validity of the tool and identify its ability to predict emergencydepartment overcrowding.3. Simultaneously, we used the tool to survey the emergency visiting regularity fromJanuary1,2012to December31,2012of a3A grade hospital in Shanghai and explorethe main impacting factors of emergency department overcrowding. The data obtainedfrom the above survey were inputted to SPSS18.0and Medcle for statistical treatment.[Results]1. The study first imported modified National Emergency Department OvercrowdingScale which was composed of7assessment items. The content validity anddiscrimination validity were all good. The Spearman Correlation Coefficient of thesubjective emergency department overcrowding scoring and modified NEDOCS was0.824which showed that they have good consistency.2. Basing on modified NEDOCS, the study preliminary analyzed the emergencyvisiting information and regularity by day, month and quarter as the basic unit. Then use Bland-Alman method of consistency test with the number of single index andtemporary infusion accounted for the total number of visits, observation proportionpercentage of the total number of patients and the average door–drug time. The resultsshowed that there was1point out of the LOA range of all31points, the ratio was3.23%, less than5%. The modified NEDOCS scoring tool could be interchanged withthe single index evaluation methods which showed that they have good consistency.[Conclusion]On the basis of Delphi Method and preliminary test, the modified NEDOCS scoringtool was developed. It was confirmed scientific, reasonable, stable and highlyvaluable for emergency department overcrowding evaluation. The good credibility,feasibility and practicality of the modified NEDOCS may transform empiricaljudgment into objective scale of emergency overcrowding degree and provide a basisfor taking intervention measures at all levels of emergency management.