The emergency healthcare system in Trauma Service Area E is dealing with seasonally recurring regional issues related to patient surge.  The following contains information regarding requests for increased NEDOCS reporting frequency as well as existing regional policies for reporting hospital capabilities and capacities in EMResource.

Update NEDOCS Twice Daily

Based on recent input from hospital partners, NCTTRAC is requesting that hospitals begin updating their NEDOCS in EMResource at least once every 12 hours.  NEDOCS is a useful tool for indicating the degree of saturation of an emergency department, and more frequent NEDOCS updates provide increased situational awareness for hospitals and EMS partners regarding the state of the emergency healthcare system in their community.

Hospital users can update the NEDOCS for their facility by logging in to EMResource and clicking on the current NEDOCS for their facility.  Then, fill in the variables to calculate your facility’s NEDOCS.  Please see the attached “EMResource NEDOCS Guide” for detailed instructions on updating your facility’s NEDOCS.

Advisory vs. Closed

Many regional Emergency Departments are experiencing overcrowding due to high patient demand.  As facilities use EMResource to report their capacity issues, NCTTRAC would like to refresh its Members and healthcare partners on the appropriate use of the “Advisory” status and the “Closed” status as defined by the Regional Trauma System Plan (p.22-23):

“Facilities may choose from status values of “Open”, “Closed”, or “Advisory”.  “Advisory” is used when there is a situation at the facility that affects operations but doesn’t require closure; the specifics are indicated in the other columns as appropriate or in the “Comments” area.  ED personnel are required to monitor and update their ED status at least once each day … A facility may post a “Closed” status only if they are suffering from a facility emergency.  Examples may include an internal disaster such as a fire, flooding, power outage, water shortage, or structural damage.”

• “Advisory” status should be used if you are informing EMS about interruptions to internal services that may impact patient care, including bed availability issues that affect wait times.  Proper selection of the “Advisory” status and the addition of specific comments is critical to the efficient operation of the regional emergency healthcare system.
• “Closed” status is to reflect an internal disaster within a facility that shuts down an emergency department to new patients whether EMS or self-presented.  “Closed” should not be used to show that a facility has limited bed availability resulting in long wait times for EMS.

If you have any questions, please contact NCTTRAC_EMCC@NCTTRAC.org.  For Emergencies, contact the 24/7 Duty Phone at 817-607-7020.