Objective: To assess the development, use, and implementation of a predictive two-hour forecasting tool for Emergency Department overcrowding. Validate a forecasted Bed Ratio with the National Emergency Department Overcrowding Scale (NEDOCS) and Bed Ratio (BR) to determine accuracy and benefit of use.

Methods: This research study utilized tools that identified overcrowding to establish a reliable two-hour forecasting tool within the Emergency Department. It included the use of the Dixon Forecasting Model (DFM), BR, and the NEDOCS. A combination of two tools, the DFM and BR, was utilized to forecast overcrowding based on current census. This two-hour forecast was validated by the NEDOCS and BR, which have been acknowledged in the identification of real-time overcrowding (Jones, 2006).

Data Analysis: The two-hour forecasted BR is moderately correlated with the NEDOCS and BR at the forecasted time. This is evidenced by a correlation coefficient of 0.508 with the NEDOCS and a correlation coefficient of 0.492 with the BR. Further data analysis revealed a strong correlation between the NEDOCS and the BR, as evidenced by a correlation coefficient of 0.949.

Conclusion: Results of this study suggest that the DFM can be used in combination with the BR to calculate a two-hour forecasted BR. This data would also indicate that using either BR or NEDOCS in real-time to determine overcrowding is effective. One limitation of the study involves criteria set forth for predicted departures in two hours. Creating an automated forecasting tool for Skinner/Forecasting Emergency Department Overcrowding 97 departures, similar to the DFM’s forecasting of arrivals, could prove beneficial.