Comparison of Overcrowding Measures: A Data-Driven Approach for Emergency Departments

This thesis focuses on the overcrowding issue in the Emergency Department (ED). Thanks to the rising availability of process and patient-related data, the scientific literature has developed various indicators to manage real-time overcrowding. However, concrete evidence of their actual effectiveness is still lacking. Consequently, this thesis aimed to assess whether these measures are truly capable of representing the overcrowding phenomenon. Specifically, it was analysed the relationship between NEDOCS, EDWIN and Occupancy Level and some consequences of crowding, such as prolonged Length of Stay (LOS), increased waiting time before seeing a physician, and higher rates of Leaving Without Being Seen (LWBS). Such an assessment was made possible by the availability of real data from an Italian ED. The results indicate that all three indicators can be used to assess overcrowding in real-time, with Occupancy Level being the preferred option. However, they carry limitations in terms of efficiency and timeliness in the interventions they trigger, highlighting the need to develop better tools for monitoring the overcrowding in real time.