RT Journal Article
SR Electronic
T1 Use of the SONET score to evaluate Urgent Care Center overcrowding: a prospective pilot study
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e006860
DO 10.1136/bmjopen-2014-006860
VO 5
IS 4
A1 Hao Wang
A1 Richard D Robinson
A1 Chad D Cowden
A1 Violet A Gorman
A1 Christopher D Cook
A1 Eugene K Gicheru
A1 Chet D Schrader
A1 Rani D Jayswal
A1 Nestor R Zenarosa
YR 2015
UL http://bmjopen.bmj.com/content/5/4/e006860.abstract
AB Objectives To 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.Design Prospective pilot study.Setting Single centre study in the USA.Participants 3565 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 measures A 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.Results Four 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).Conclusions The 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.