? ? Emergency Department (ED) crowding has become an unresolved national crisis for more than a decade. Crowding affects the safety of patients on a daily basis and exposes them to an increased risk of harm through decreased access to scarce critical resources. The lack of an integrated systems framework and the difficulties of measuring potential crowding factors in real-time contribute to the failure of finding effective solutions. The goal of this project is to apply information technology to implement a conceptual, nationally developed, ? consensus-based measurement framework to characterize ED crowding. The crowding ? measures will be used to develop a probabilistic, early warning decision support system that is able to ? predict ED diversion in real time. The decision support system will be integrated with our advanced ED ? information system infrastructure. In a prospective pilot evaluation we will study the impact of the ? probabilistic decision support system's ability to ameliorate reversible causes of ED crowding and examine the system's accuracy for predicting ED diversion. ? ? The following objectives will be achieved: ? ? Aim 1: Create an integrated health information system infrastructure that allows the real-time collection of ED crowding measures. ? ? Aim 2: Collect ED crowding measures prospectively during a 4-month period as the foundation for ? developing an early warning system for ED overcrowding. ? ? Aim 3: Develop and implement a real-time, probabilistic decision support system for ED crowding. ? ? Aim 4: Prospectively evaluate the impact of the decision support system on ED crowding during a pilot evaluation study. ? ?

Agency
National Institute of Health (NIH)
Institute
National Library of Medicine (NLM)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21LM009002-02
Application #
7229889
Study Section
Special Emphasis Panel (ZLM1-HS-R (O1))
Program Officer
Sim, Hua-Chuan
Project Start
2006-03-04
Project End
2008-02-29
Budget Start
2007-03-01
Budget End
2008-02-29
Support Year
2
Fiscal Year
2007
Total Cost
$160,102
Indirect Cost
Name
Vanderbilt University Medical Center
Department
Emergency Medicine
Type
Schools of Medicine
DUNS #
004413456
City
Nashville
State
TN
Country
United States
Zip Code
37212
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Hoot, Nathan R; Epstein, Stephen K; Allen, Todd L et al. (2009) Forecasting emergency department crowding: an external, multicenter evaluation. Ann Emerg Med 54:514-522.e19
Hoot, Nathan R; Aronsky, Dominik (2008) Systematic review of emergency department crowding: causes, effects, and solutions. Ann Emerg Med 52:126-36
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Aronsky, Dominik; Jones, Ian; Lanaghan, Kevin et al. (2008) Supporting patient care in the emergency department with a computerized whiteboard system. J Am Med Inform Assoc 15:184-94
McCarthy, Melissa L; Aronsky, Dominik; Jones, Ian D et al. (2008) The emergency department occupancy rate: a simple measure of emergency department crowding? Ann Emerg Med 51:15-24, 24.e1-2
Hoot, Nathan R; Zhou, Chuan; Jones, Ian et al. (2007) Measuring and forecasting emergency department crowding in real time. Ann Emerg Med 49:747-55
Levin, Scott; Aronsky, Dominik; Hemphill, Robin et al. (2007) Shifting toward balance: measuring the distribution of workload among emergency physician teams. Ann Emerg Med 50:419-23
McCarthy, Melissa L; Aronsky, Dominik; Kelen, Gabor D (2006) The measurement of daily surge and its relevance to disaster preparedness. Acad Emerg Med 13:1138-41

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