Quality Improvement Project Optimization of Bed Capacity Management at a Tertiary Pediatric Facility
Degree Name
Nursing Practice, DNP
Publication Date
9-15-2025
First Advisor
Lisa Drake
Second Advisor
Diane Hare
Abstract
Emergency department (ED) overcrowding can be defined as a circumstance in which the number of patients seeking care has exceeded the resources available. ED overcrowding can have significant negative impacts on patient safety, quality of care, and hospital finances. The use of an ED saturation measurement is supported by research and widely used in adult emergency departments. The quality improvement project evaluated the correlation between a modified National Emergency Department Crowding Scale (mNEDOCS) and established ED metrics- length of stay (LOS) and left-without-being-seen (LWBS) rates. The intervention was guided by the revised Iowa Model and the Model for Improvement, both of which offered a structured approach to process improvement and change management. The project was a paired quantitative correlational study design that evaluated data from a single tertiary level I and academic pediatric emergency department over a six-week period. Plan-Do-Study-Act was utilized to guide implementation. Descriptive statistics and Spearman correlation were calculated to evaluate the association between specific ED metrics and mNEDOCS. Results demonstrated a strong positive correlation between mNEDOCS scores and both quality metrics – LWBS rates with a correlation of .57 (p<.001, 95% CI = [.32, .75]) and ED LOS with a correlation of .56 (p<.001, 95% CI = [.29, .74]). These findings were consistent with the existing literature and indicate that mNEDOCS is a reliable tool for driving hospital bed capacity management plans. This study illustrates the utility of mNEDOCS as a measure of overcrowding in a pediatric ED.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Stewart, Barbara M., "Quality Improvement Project Optimization of Bed Capacity Management at a Tertiary Pediatric Facility" (2025). Doctor of Nursing Practice Projects. 227.
https://arch.astate.edu/dnp-projects/227
