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    Patent Pending

    PEDOCS Score for Pediatric Emergency Department Overcrowding

    Estimates severity of overcrowding in pediatrics emergency departments.
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    When to Use
    Pearls/Pitfalls
    Why Use

    Many EDs are using these scores every shift, or at times on shift with drastic changes in crowding (large influx of patients, for example).

    • PEDOCS was created as an improved analysis over the NEDOCS scoring system; both assess and quantify ED overcrowding.
    • PEDOCS was developed specifically with pediatric emergency departments in mind.
      • NEDOCS only targeted large, academic trauma centers.
    • Interestingly, its score was calibrated by comparing “busy-ness” to ratings by emergency physicians and emergency department charge nurses.

    Points to keep in mind:

    • The PEDOCS score should have additional validation done to verify its generalizabilty to other hospitals.

    Providing an objective, quantitative score can help EDs and their hospitals provide appropriate resources to the ED and rest of the hospital to reduce delays in care, and boarding, which have been shown to have significant impacts on patient morbidity and mortality.

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    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    Perform a crowding score assessment every shift, as well as at times of large influxes of patients to the ED.

    Management

    Many hospitals have developed “surge plans” similar to disaster plans that provide additional resources to the hospital and ED when an ED goes above a certain score threshold.

    Formula

    Pediatric ED Overcrowding Scale (PEDOCS)= 33.3 * [0.11 + 0.07 * (patients in the waiting room)+ 0.04 * (total registered patients)]

    Facts & Figures

    Score interpretation:

    Level Score Interpretation
    Level 1 1-20 Not busy
    Level 2 21-60 Busy
    Level 3 61-100 Extremely busy but not overcrowded
    Level 4 101-140 Overcrowded
    Level 5 141-180 Severely overcrowded
    Level 6 181-200 Dangerously overcrowded
    Dr. Steven Weiss

    About the Creator

    Steven Weiss, MS, MD FACP, FACEP, is a professor of medicine at University of New Mexico. He is presently the medical director of the Critical Care Transport Team for AAS. Dr. Weiss is the creator of both the CEDOCS, NEDOCS, and the more recent PEDOCS, and he is an avid researcher in Emergency Medicine, working towards ways to improve efficiency and efficacy of ED workflow.

    To view Dr. Steven Weiss's publications, visit PubMed