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Multi-dimensional Measurements of Crowding for Pediatric Emergency Departments: A Systematic Review
Areej Abudan1, Roland C Merchant2
1Ministry of Health, Kingdom of Saudi Arabia, Riyadh, Saudi Arabia.
Insights
Pediatric emergency departments (EDs) lack validated crowding measurement tools. This review examined four studies developing such tools, finding promising but early-stage progress in measuring pediatric ED crowding.
Area of Science:
- Emergency Medicine
- Healthcare Management
- Pediatric Care
Background:
- * Measuring crowding in pediatric emergency departments (EDs) is crucial for improving patient care and operational efficiency.
- * Existing crowding measurement tools often fail to capture the unique complexities of pediatric EDs.
- * There is a need for validated, multidimensional tools to assess and address pediatric ED crowding.
Purpose of the Study:
- * To systematically review studies on the development and testing of multidimensional crowding measurement tools specifically for pediatric EDs.
- * To identify existing models and approaches for quantifying pediatric ED crowding.
Main Methods:
- * A systematic review of four studies that reported on the development and testing of pediatric ED crowding measurements.
- * Analysis of studies focusing on factors indicative of crowding, patient flow models, and physician workload models.
Main Results:
- * Four studies reported on the development and testing of multidimensional pediatric ED crowding measurement tools.
- * Models examined included those measuring crowding factors (PEDOCS, SOTU-PED), patient flow, and physician workload.
- * The reviewed works show promise but indicate the field of pediatric ED crowding measurement is in its early stages.
Conclusions:
- * Current multidimensional crowding measurement tools for pediatric EDs show potential.
- * Further research is needed to compare the utility and validity of these tools across diverse pediatric ED settings.
- * Advancing pediatric ED crowding measurement is essential for developing effective solutions.
Abstract:
The absence of accepted crowding measurement tools that encompass the unique characteristics of pediatric emergency departments (EDs) creates a deficit in advancing efforts to identify and evaluate solutions for this growing problem. In this systematic review, we examined 4 studies that reported on the development and testing of multidimensional pediatric ED crowding measurements. Two investigations involved models (PEDOCS, SOTU-PED) that measured factors indicative or contributory to crowding. A third investigation developed a model mapping the flow of patients through the pediatric ED. The final study modeled the magnitude of physician's work load, particularly when this load is high when crowding is likely present, based on patient arrivals, presenting complaints and conditions, and tests ordered. These works from 4 studies on measuring crowding in pediatric EDs show promise, but this field is at an early stage. Future work should concentrate on comparing the utility of crowding measurements across multiple pediatric ED settings.
