Development and Implementation of the Modified Pediatric Emergency Department Overcrowding Scale in Two Large Academic Pediatric Centers

Emergency department crowding is a chronic problem within health care systems. The consequences of crowding are well documented with negative impacts on patient outcomes, patient/family satisfaction, staff stress, and medical errors. This study describes the implementation of the Pediatric Emergency Department Overcrowding Scale in 2 emergency departments, a 45-bed and a 22-bed, within a large pediatric academic medical center. Initial work revealed the scale worked well at a 45-bed emergency department but significantly underreported crowding at the 22-bed emergency department. A bed capacity correction factor was developed and incorporated in the Pediatric Emergency Department Overcrowding Scale formula, thus standardizing the view of crowding in each emergency department. The modified Pediatric Emergency Department Overcrowding Scale provided real-time visualization of crowding in both emergency departments and health care system capacity management systems. The modified Pediatric Emergency Department Overcrowding Scale was shared with a pediatric emergency department within another large academic pediatric medical center. Implementation of the bed capacity correction factor into their system resulted in a similarly improved demonstration of emergency department crowding through the Pediatric Emergency Department Overcrowding Scale.