. 2021 Feb 27;8:2333794X21999153. doi: 10.1177/2333794X21999153

Table 2.

Summary of Pediatric Emergency Department Multidimensional Crowding Measurement Investigations.

References	Study setting, population, study year, pediatric ED LOS	Crowding measurement	Crowding measurement performance
Weiss et al²⁶	Jackson Memorial Hospital pediatric ED, Miami	Pediatric ED Overcrowding Scale (PEDOCS), a scale ranging from 0 to 200 (0, not busy; 40, busy; 80, extremely busy but not overcrowded; 120, overcrowded; 160, severely overcrowded; 200, dangerously overcrowded)	Spearman correlation 0.81 between PEDOCS and pediatric staff (nurse and physician) perception of crowding, as compared to NEDOCS Spearman correlation of 0.70 with pediatric staff perception of crowding
	32 225 patient visits/year (2002)	PEDOCS = 33.3 * 0.11 + 0.07(patients in the waiting room) + 0.04(total registered patients)
	February 5 to 25, 2002
	Median LOS: 135 (IQR 120-330) minutes, longest LOS: 227 ± 189.4 (SD)
Noel et al²⁸	North Hospital, Assistance Publique Hopitaux de Marseille pediatric ED	Linear model (SOTU-PED) to predict global hourly crowding perception	Correlation between global hourly crowding perception and SOTU-PED: 0.824 (P < .001)
	During model development period: mean LOS 160 (SD 13.1) minutes, median LOS 162 (IQR 152-169) minutes	SOTU-PED = 0.764 + 0.49 Census-H24 (number of admissions in the past 24 hours) + 0.496 Occ-Rate (occupancy rate) + 0.302 1-year infant (number of patients <1 year old) + 0.005 WT-Triage (waiting time for triage) + 0.002 WT-Med (waiting time for medical evaluation)	Prediction of global hourly crowding perception score >5 for SOTU-PED of 2 or greater, AUC: 0.957 (95% CI: 0.933-0.980), odds ratio: 51.88 (95% CI: 20.42-131.83), sensitivity 89.5% (95% CI: 0.79-0.95), specificity 85.9% (95% CI: 0.81-0.90), positive likelihood ratio: 8.16 (95% CI, 3.82-17.43), negative likelihood ratio: 0.157 (95% CI: 0.11-0.22), positive predictive value: 63.7% (95% CI: 60.9-66.4), and negative predictive value: 96.7% (95% CI: 94.3-98.7)
	During model validation period: mean LOS 153 (SD 14.6) minutes, median LOS 152 (140-165) minutes
	36 000 patient visits/year (2016)
	November 25, 2016 to January 25, 2017
Ajmi et al³⁰	Regional University Hospital Center (CHRU), Lille, France, pediatric ED	Model of flow through the pediatric emergency department based on 3 primary stages: patient arrival and initial assessment, patient (re)orientation and treatment, and patient destinations	Three separate models were identified for summer, winter, and crisis periods (overcrowding)
	January 2011 to December 2012	The model produced minimum and maximum average waiting times for patients as they progress through stages of care
	23 150 patient visits/year (2011) and 24 039/year (2012)
	Summer period waiting times: 30 minutes to 2:30 hours
	Winter period waiting times: 1 to 4 hours
	Crisis (crowding) period waiting times: up to 10 hours
Chandoul et al³³	Regional University Hospital Center (CHRU), Lille, France, pediatric ED	Model of healthcare treatment load (burden of care provided to patients by medical staff)	Model could predict during a day when total healthcare treatment load was high (75% and 95% upper limits of distribution of healthcare treatment load)
	January 2011-December 2012 for model development, January-November 2013 for model testing	Model used distributions of patient lengths of stay from 1.186 patient presentations (complaints and conditions) as influenced by number of tests performed
	23 150 patient visits/year (2011) and 24 039/year (2012)
	Median LOS (included cases only): 132 (IQR 87-196) minutes

Abbreviations: LOS, length of stay; IQR, interquartile range; SD, standard deviation; AUC, area under the curve; CI, confidence interval; SOTU-PED in French, Score Objectif de Tension dans les services d’Urgences pediatriques (English translation: quantitative scale for crowding in pediatric emergency department); NEDOCS, adult national emergency department overcrowding scale.