• Adrian Boyle, Paul Atkinson, Carlos Basaure Verdejo, Edward Chan, Robin Clouston, Paedar Gilligan, Karan Grewal, Ian Higginson, Paul Liston, Virginia Newcombe, Valerie Norton, Sophie Richter, George Stoica, and Abel Wakai.
• Addenbrookes Hospital.
• Eur J Emerg Med. 2019 Dec 1; 26 (6): 405-411.

ObjectiveThere is little consensus on the best way to measure emergency department (ED) crowding. We have previously developed a consensus-based measure, the International Crowding Measure in Emergency Departments. We aimed to externally validate a short form of the International Crowding Measure in Emergency Department (sICMED) against emergency physician's perceptions of crowding and danger.MethodsWe performed an observational validation study in seven EDs in five different countries. We recorded sICMED observations and the most senior available emergency physician's perceptions of crowding and danger at the same time. We performed a times series regression model.ResultsA total of 397 measurements were analysed. The sICMED showed moderate positive correlations with emergency physician's perceptions of crowding, r = 0.4110, P < 0.05) and safety (r = 0.4566, P < 0.05). There was considerable variation in the performance of the sICMED between different EDs. The sICMED was only slightly better than measuring occupancy or ED boarding time.ConclusionThe sICMED has moderate face validity at predicting clinician's concerns about crowding and safety, but the strength of this validity varies between different EDs and different countries.

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