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Conceptual Map Running head: CONCEPTUAL MAP

Conceptual Map Sandra Rizzo University of Phoenix Measuring Performance Standards HCS 588 Monique Norfus June 11, 2009

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Conceptual Map

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Conceptual Map The conceptual map is constructed from an article entitled, “increase in patient mortality at 10 days associated with emergency department overcrowding” (Richardson, 2006). The article described a study which sought to quantify any relationship between emergency department (ED) overcrowding and 10 day patient mortality. The research used was a retrospective stratified cohort analysis of three 48 week periods in an ED. Occupancy rates in the ED was a measure used to calculate overcrowding based on the number of patients receiving treatment. As stated by Ricardson (2006), mean occupancywas calculated for 8-hour shifts and for 12-week periods. The shifts of each type with the highest number of patients were classified as overcrowded. Participants were then classified into those arriving during “overcrowded” shifts and those arriving during an equivalent number of “not overcrowded” shifts. The main outcome measure were the number of in-hosptital deaths occurring within 10 days of the most recent ED presentation. The deaths were divided into groups of those whose ED visits were during times of overcrowding, and those who were seen in the ED during not overcrowded conditions. Data collected included patient age and gender, time to triage, time to disposition, and day and shift of arrival.

Conceptual Map VARIABLES; 1. ED occupancy 2. time of day 3. day of week 4. hospital occupancy 5. season 6. EMS diversion PATTERNS; ED OVERCROWDING>>>>> ED DYSFUNCTION>>>> LONGER WAITING TIMES>>>> INCREASED DELAYS IN ADMISSIONS TO HOSPITAL>>>> INCREASE TRANSMISSION OF INFECTIOUS DISEASE>>>> DELAY IN TRANSFER TO INPATIENT BED FROM ED>>>> INCREASED LENGTH OF STAY>>>> INCREASE PATIENT MORTALTY

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