• Jérôme Jobé, Anne-Françoise Donneau, Béatrice Scholtes, and Alexandre Ghuysen.
• a Emergency Department , University Hospital of Liege , Liege , Belgium.
• Acta Clin Belg. 2018 Jun 1; 73 (3): 207-212.

IntroductionEmergency department (ED) crowding is a major international concern with a negative impact on both patient care and providers. Currently, there is no consensus regarding measure of crowding. Therefore, emergency physicians have to choose between numerous scoring systems, from simple to more complex. The aim of the present study was to compare the complex National Emergency Department Overcrowding Scale (NEDOCS) with the simple ED Occupancy rate (OR) determination. We further evaluated the correlation between these scores and a qualitative assessment of crowding.MethodThis study was conducted in two academic and one regional hospital in Liege Province, in Belgium; each accounting for an ED census of over 40,000 patient visits per year. Crowding measures were sampled four times a day, over a two-week period, in January 2016.ResultsED staff considered overcrowding as a major concern in the three ED. Median OR ranged from 68 to 100, while NEDOCS ranged from 64.5 to 76.3. A significant correlation was found in each ED between the OR and the NEDOCS (Pearson r = 0.973, 0.974 and 0.972), as well as between the OR, the NEDOCS and the subjective evaluation by the ED staff (p = 0.001).ConclusionCrowding evaluation in ED requires validated scores. Our study in three different hospitals demonstrates that simple OR appeared as accurate as more sophisticated NEDOCS. Furthermore, this measure is perfectly correlated with the feeling of ED staff.

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