A New Crowding Indicator in the Emergency Department

Comparison Between a New Crowding Indicator and the Perception of Healthcare Workers in the Emergency Department

Status

Active, not recruiting

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT07111624

Enrollment

828

Registered

2025-08-08

Start date

2025-10-15

Completion date

2026-12-31

Last updated

2026-05-20

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Crowding, Emergency Department

Brief summary

Fenice has proposed a new indicator to measure the level of crowding in the ER. The aim of this study is to evaluate, in a national multicenter context, the degree of agreement between the Fenice indicator and the perception of crowding of the ER operators and to compare this agreement with that between NEDOCS and the perception of the operators.

Detailed description

The NEDOCS (National Emergency Department OverCrowding Study) is currently the most widely used indicator in Italy to measure the level of crowding in Emergency Departments (EDs). However, despite its widespread use, it presents several critical issues. First of all, it was developed in a context very different from the current Italian one, since it was built on data collected in 2002 in 8 medium-large US university EDs. It is therefore not possible to take for granted that this indicator can accurately describe the current crowding conditions of Italian EDs. Furthermore, the factors that make up the NEDOCS are often calculated differently by the various hospital facilities, compromising the comparability of the estimates. Fenice has proposed a new indicator to measure the level of crowding in EDs. The indicator was developed to measure one of the objective consequences of crowding in EDs, namely the increase in waiting time for patients with a problem classified as minor urgency or deferrable to triage (codes 3 and 4). In parallel, the Fenice study has shown that NEDOCS is not very sensitive to this objective consequence of crowding. The aim of this study is to evaluate, in a national multicenter context, the degree of agreement between the Fenice indicator and the perception of crowding of the operators of the ER and to compare this agreement with that between NEDOCS and the perception of the operators.

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

CROSS_SECTIONAL

Eligibility

Sex/Gender

ALL

Healthy volunteers

Inclusion criteria

Patients that are in EDs at the time of the survey

Exclusion criteria

Patients that are in EDs, but not at the time of the survey

Design outcomes

Primary

Measure	Time frame	Description
Proportion of variation in the ED staff perceived crowding level that is explained by the Fenice crowding score.	September 2025 - December 2025	The outcome will be measured using the coefficient of determination (referred to as R2) of the linear model regressing the perceived level of crowding on the Fenice score.

Secondary

Measure	Time frame
Proportion of variation in the ED staff perceived crowding level that is explained by the NEDOCS score, measured using the coefficient of determination (R2) of the linear model regressing the perceived level of crowding on the NEDOCS score.	September 2025 - December 2025

Countries

Italy

Contacts

STUDY_CHAIRGiovanni Nattino

Istituto di Ricerche Farmacologiche Mario Negri IRCSS

Outcome results