Creation and piloting of a new hospital capacity assessment tool in a major urban area.
OBJECTIVE
Crowded hospital emergency departments (EDs) can undermine the ability of a region's safety net to provide safe, timely care. However, data to measure hospital capacity community-wide is generally unavailable. This study aimed to assess hospital crowding, capacity and patient flow in an urban community using the newly developed hospital capacity assessment tool (HCAT).


METHODS
A survey of the eight acute care hospitals in the District of Columbia (DC) with active EDs.


METHODS
Existing emergency care assessment tools were reviewed. Eighteen of the 57 questions on the HCAT were adapted from existing hospital surveys, while the remaining 39 questions were constructed de novo for use in this assessment. Hospitals were provided with paper and electronic versions of the HCAT.


RESULTS
All eight DC hospitals completed the HCAT; however, three hospitals were unable to answer many of the questions due to a lack of regular data collection. The HCAT data shows throughput times in DC hospitals that are substantially longer than national averages.


CONCLUSIONS
The HCAT is a promising tool for evaluating community-wide emergency care. Findings from the HCAT allowed for the introduction of new ED performance data into the local decision-making process.
Siegel
B
B
School of Public Health and Health Services, George Washington University, Washington, DC, USA. bruce.siegel@gwumc.edu
Norton
B L
BL
Blanchard
J C
JC
Regenstein
M
M
Jones
K C
KC
D001509:Bed Occupancy / Q000706:statistics & numerical data; D003441:Crowding; D004219:District of Columbia; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data; D016304:Hospitals, Private / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D020380:Needs Assessment; D010360:Patient Transfer; D010561:Personnel Staffing and Scheduling; D010865:Pilot Projects; D014850:Waiting Lists; D000078329:Workforce