A New Crowding Indicator in the Emergency Department

Fenice has proposed a new indicator to measure the level of crowding in the ER. The aim of this study is to evaluate, in a national multicenter context, the degree of agreement between the Fenice indicator and the perception of crowding of the ER operators and to compare this agreement with that between NEDOCS and the perception of the operators.

Active, Not Recruiting

This study is active but is not currently recruiting participants.

Key information

Conditions

Emergency Department Behavior Crowding Disease Attributes Emergencies Pathologic Processes Pathological Conditions, Signs and Symptoms Spatial Behavior

Sex eligibility

All sexes

Study type

Observational

Primary location

Spedali civili, Brescia, BS, Italy

About this study

The NEDOCS (National Emergency Department OverCrowding Study) is currently the most widely used indicator in Italy to measure the level of crowding in Emergency Departments (EDs). However, despite its widespread use, it presents several critical issues. First of all, it was developed in a context very different from the current Italian one, since it was built on data collected in 2002 in 8 medium-large US university EDs. It is therefore not possible to take for granted that this indicator can accurately describe the current crowding conditions of Italian EDs. Furthermore, the factors that make up the NEDOCS are often calculated differently by the various hospital facilities, compromising the comparability of the estimates.

Fenice has proposed a new indicator to measure the level of crowding in EDs. The indicator was developed to measure one of the objective consequences of crowding in EDs, namely the increase in waiting time for patients with a problem classified as minor urgency or deferrable to triage (codes 3 and 4). In parallel, the Fenice study has shown that NEDOCS is not very sensitive to this objective consequence of crowding.

The aim of this study is to evaluate, in a national multicenter context, the degree of agreement between the Fenice indicator and the perception of crowding of the operators of the ER and to compare this agreement with that between NEDOCS and the perception of the operators.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Patients that are in EDs at the time of the survey

Exclusion criteria

Patients that are in EDs, but not at the time of the survey

Treatment and study plan

Primary outcomes

Proportion of variation in the ED staff perceived crowding level that is explained by the Fenice crowding score.

Time frame: September 2025 - December 2025

The outcome will be measured using the coefficient of determination (referred to as R2) of the linear model regressing the perceived level of crowding on the Fenice score.

Secondary outcomes

Proportion of variation in the ED staff perceived crowding level that is explained by the NEDOCS score, measured using the coefficient of determination (R2) of the linear model regressing the perceived level of crowding on the NEDOCS score.

Time frame: September 2025 - December 2025

Sponsors and collaborators

Lead sponsor

Mario Negri Institute for Pharmacological Research

Other

Registry information

Official study title

Comparison Between a New Crowding Indicator and the Perception of Healthcare Workers in the Emergency Department

Important dates

Study start: 2025
Primary completion: 2025
Study completion: 2026
First posted: Aug 8, 2025
Registry last updated: May 20, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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Active, Not Recruiting