title: Use of the SONET score to evaluate Urgent Care Center overcrowding: a prospective pilot study.
abstract: OBJECTIVE
  To derive a tool to determine Urgent Care Center (UCC) crowding and investigate the association between different levels of UCC overcrowding and negative patient care outcomes.
  
  
  METHODS
  Prospective pilot study.
  
  
  METHODS
  Single centre study in the USA.
  
  
  METHODS
  3565 patients who registered at UCC during the 21-day study period were included. Patients who had no overcrowding statuses estimated due to incomplete collection of operational variables at the time of registration were excluded in this study. 3139 patients were enrolled in the final data analysis.
  
  
  METHODS
  A crowding estimation tool (SONET: Severely overcrowded, Overcrowded and Not overcrowded Estimation Tool) was derived using the linear regression analysis. The average length of stay (LOS) in UCC patients and the number of left without being seen (LWBS) patients were calculated and compared under the three different levels of UCC crowding.
  
  
  RESULTS
  Four independent operational variables could affect the UCC overcrowding score including the total number of patients, the number of results pending for patients, the number of patients in the waiting room and the longest time a patient was stationed in the waiting room. In addition, UCC overcrowding was associated with longer average LOS (not overcrowded: 133±76 min, overcrowded: 169±79 min, and severely overcrowded: 196±87 min, p<0.001) and an increased number of LWBS patients (not overcrowded: 0.28±0.69 patients, overcrowded: 0.64±0.98, and severely overcrowded: 1.00±0.97).
  
  
  CONCLUSIONS
  The overcrowding estimation tool (SONET) derived in this study might be used to determine different levels of crowding in a high volume UCC setting. It also showed that UCC overcrowding might be associated with negative patient care outcomes.
authors: Department of Emergency Medicine, Integrative Emergency Services Physician Group, John Peter Smith Health Network, Fort Worth, Texas, USA.
authors: Hao
authors: H
authors: Wang
authors: Department of Emergency Medicine and Urgent Care Center, Integrative Emergency Services Physician Group, John Peter Smith Health Network, Fort Worth, Texas, USA.
authors: Richard D
authors: RD
authors: Robinson
authors: Department of Emergency Medicine and Urgent Care Center, Integrative Emergency Services Physician Group, John Peter Smith Health Network, Fort Worth, Texas, USA.
authors: Chad D
authors: CD
authors: Cowden
authors: Department of Emergency Medicine and Urgent Care Center, Integrative Emergency Services Physician Group, John Peter Smith Health Network, Fort Worth, Texas, USA.
authors: Violet A
authors: VA
authors: Gorman
authors: Department of Emergency Medicine and Urgent Care Center, Integrative Emergency Services Physician Group, John Peter Smith Health Network, Fort Worth, Texas, USA.
authors: Christopher D
authors: CD
authors: Cook
authors: Department of Emergency Medicine and Urgent Care Center, Integrative Emergency Services Physician Group, John Peter Smith Health Network, Fort Worth, Texas, USA.
authors: Eugene K
authors: EK
authors: Gicheru
authors: Department of Emergency Medicine and Urgent Care Center, Integrative Emergency Services Physician Group, John Peter Smith Health Network, Fort Worth, Texas, USA.
authors: Chet D
authors: CD
authors: Schrader
authors: Department of Emergency Medicine and Urgent Care Center, Integrative Emergency Services Physician Group, John Peter Smith Health Network, Fort Worth, Texas, USA.
authors: Rani D
authors: RD
authors: Jayswal
authors: Department of Emergency Medicine and Urgent Care Center, Integrative Emergency Services Physician Group, John Peter Smith Health Network, Fort Worth, Texas, USA.
authors: Nestor R
authors: NR
authors: Zenarosa
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D003441:Crowding; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D010865:Pilot Projects; D011446:Prospective Studies; D014850:Waiting Lists
keywords: ACCIDENT & EMERGENCY MEDICINE