BACKGROUND Overcrowding in emergency departments (EDs) is internationally recognized as one of the greatest challenges to healthcare provision. Numerous studies have highlighted the ill-effects of overcrowding, including increased length of stay, mortality and cost per admission. This study measures overcrowding in EDs through health care professionals' perceptions of it, comparing the results with the NEDOCS score, an objectively validated measurement tool and describing meaningful tools and strategies used to manage ED overcrowding. METHODS This single-centre prospective, observational, pilot study was conducted from February 19th to March 7th, 2018 at the ED in the University Hospital of Ferrara, Italy to measure the agreement of the NEDOCS, comparing objective scores with healthcare professionals' perception of overcrowding, using the kappa statistic assessing linear weights according to Cohen's method. The tools and strategies used to manage ED overcrowding are described. RESULTS Seventy-two healthcare professionals (66.1% of 109 eligible subjects) were included in the analyses. The study obtained a total of 262 surveys from 23 ED physicians (31.9%), 31 nurses (43.1%) and 18 nursing assistants (25.0%) and a total of 262 NEDOCS scores. The agreement between the NEDOCS and the subjective scales was poor (k = 0.381, 95% CI 0.313-0.450). CONCLUSIONS The subjective health care professionals' perceptions did not provide an adequate real-time measure of the current demands and capacity of the ED. A more objective measure is needed to make quality decisions about health care professional needs and the ability to manage patients to ensure the provision of proper care.

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医护人员的看法是否有助于衡量急诊科人满为患的程度？在意大利大学医院进行试点研究。

背景技术在国际上，急诊室的人满为患是医疗服务面临的最大挑战之一。大量研究强调了人满为患的不良影响，包括住院时间，死亡率和每次住院费用的增加。这项研究通过医疗保健专业人员的理解来衡量急诊室的人满为患，将结果与NEDOCS得分进行比较，NEDOCS得分是经过​​客观验证的测量工具，并描述了用于管理急诊室过度拥挤的有意义的工具和策略。方法这项单中心的前瞻性观察性试验研究于2018年2月19日至3月7日在意大利费拉拉大学医院急诊室进行，旨在评估NEDOCS的一致性，将客观评分与医疗保健专业人士对过度拥挤的看法进行比较，根据Cohen的方法，使用kappa统计量评估线性权重。描述了用于管理ED过度拥挤的工具和策略。结果本研究纳入了72名医疗保健专业人员（占109名合格受试者的66.1％）。该研究从23位ED医师（31.9％），31位护士（43.1％）和18位护理助手（25.0％）中获得了262次调查，并且获得了262个NEDOCS评分。NEDOCS与主观量表之间的一致性差（k = 0.381，95％CI 0.313-0.450）。结论主观卫生保健专业人员的看法不能为ED的当前需求和能力提供足够的实时度量。