ToolsCalculators
NEDOCS score for emergency department overcrowding
Regression-based estimate of overcrowding severity in academic emergency departments.
NEDOCS score for emergency department overcrowding
Total patients currently in the ED
patients
Total ED beds (staffed/licensed)
beds
Admitted patients still boarding in the ED
patients
Total hospital beds (excluding paediatric and obstetric beds)
beds
Number of ventilated / critical care patients in the ED
patients
Longest admit boarding time
hours
Waiting time of the longest-waiting patient (door-to-bed)
hours
Complete the fields above to see the result.
When to use
- Quantifying real-time overcrowding in an academic or high-volume emergency department.
- Benchmarking crowding over time or across shifts to trigger surge or diversion protocols.
Formula
NEDOCS = 85.8 x (total ED patients / ED beds) + 600 x (admitted patients still boarding / hospital beds) + 13.4 x (critical care / ventilated ED patients) + 0.93 x (longest admit boarding time, hours) + 5.64 x (waiting time of longest-waiting patient, hours) - 20. Negative results default to 0 ("not busy"). Bands: 0-20 not busy, 21-60 busy, 61-100 extremely busy, 101-140 overcrowded, 141-180 severely overcrowded, >180 dangerously overcrowded.
Pearls and pitfalls
- Derived by multivariable linear regression against physician/nurse consensus crowding ratings from 8 US academic EDs.
- The most widely used and externally validated ED crowding tool, though it was not derived in community or paediatric settings.