• Hao Wang, Richard D Robinson, Chad D Cowden, Violet A Gorman, Christopher D Cook, Eugene K Gicheru, Chet D Schrader, Rani D Jayswal, and Nestor R Zenarosa.
• Department of Emergency Medicine, Integrative Emergency Services Physician Group, John Peter Smith Health Network, Fort Worth, Texas, USA.
• BMJ Open. 2015 Jan 1; 5 (4): e006860.

ObjectivesTo derive a tool to determine Urgent Care Center (UCC) crowding and investigate the association between different levels of UCC overcrowding and negative patient care outcomes.DesignProspective pilot study.SettingSingle centre study in the USA.Participants3565 patients who registered at UCC during the 21-day study period were included. Patients who had no overcrowding statuses estimated due to incomplete collection of operational variables at the time of registration were excluded in this study. 3139 patients were enrolled in the final data analysis.Primary And Secondary Outcome MeasuresA crowding estimation tool (SONET: Severely overcrowded, Overcrowded and Not overcrowded Estimation Tool) was derived using the linear regression analysis. The average length of stay (LOS) in UCC patients and the number of left without being seen (LWBS) patients were calculated and compared under the three different levels of UCC crowding.ResultsFour independent operational variables could affect the UCC overcrowding score including the total number of patients, the number of results pending for patients, the number of patients in the waiting room and the longest time a patient was stationed in the waiting room. In addition, UCC overcrowding was associated with longer average LOS (not overcrowded: 133±76 min, overcrowded: 169±79 min, and severely overcrowded: 196±87 min, p<0.001) and an increased number of LWBS patients (not overcrowded: 0.28±0.69 patients, overcrowded: 0.64±0.98, and severely overcrowded: 1.00±0.97).ConclusionsThe overcrowding estimation tool (SONET) derived in this study might be used to determine different levels of crowding in a high volume UCC setting. It also showed that UCC overcrowding might be associated with negative patient care outcomes.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

16 keywords...

hide…