Use of the SONET score to evaluate Urgent Care Center overcrowding: a prospective pilot study.

Abstract:

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.

journal_name

BMJ Open

journal_title

BMJ open

authors

Wang H,Robinson RD,Cowden CD,Gorman VA,Cook CD,Gicheru EK,Schrader CD,Jayswal RD,Zenarosa NR

doi

10.1136/bmjopen-2014-006860

subject

Has Abstract

pub_date

2015-04-14 00:00:00

pages

e006860

issue

4

issn

2044-6055

pii

bmjopen-2014-006860

journal_volume

5

pub_type

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