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Introducing SONET UCC
Tuesday, March 19, 2019
Introducing the SONET UCC calculator. SONET UCC is a tool to determine Urgent Care Center (UCC) crowding.

Use the SONET UCC calculator to measure your urgent care.

Use of the SONET score to evaluate Urgent Care Center overcrowding: a prospective pilot study
Hao Wang,1 Richard D Robinson,2 Chad D Cowden,2 Violet A Gorman,2 Christopher D Cook,2 Eugene K Gicheru,2 Chet D Schrader,2 Rani D Jayswal,2 Nestor R Zenarosa2

Objectives: To derive a tool to determine Urgent Care Center (UCC) crowding and investigate the association between different levels of UCC overcrowding and negative patient care outcomes.

Design: Prospective pilot study. Setting: Single centre study in the USA.

Participants: 3565 patients who registered at UCC during the 21-day study period were included. Patients who had no overcrowding statuses estimated due to incomplete collection of operational variables at the time of registration were excluded in this study. 3139 patients were enrolled in the final data analysis. Primary and secondary outcome measures:
A crowding estimation tool (SONET: Severely overcrowded, Overcrowded and Not overcrowded Estimation Tool) was derived using the linear regression analysis. The average length of stay (LOS) in UCC patients and the number of left without being seen (LWBS) patients were calculated and compared under the three different levels of UCC crowding. Results: Four independent operational variables could affect the UCC overcrowding score including the total number of patients, the number of results pending for patients, the number of patients in the waiting room and the longest time a patient was stationed in the waiting room. In addition, UCC overcrowding was associated with longer average LOS (not overcrowded: 133±76 min, overcrowded: 169±79 min, and severely overcrowded: 196±87 min, p<0.001) and an increased number of LWBS patients (not overcrowded: 0.28±0.69 patients, overcrowded: 0.64±0.98, and severely overcrowded: 1.00±0.97).

Conclusions: The overcrowding estimation tool (SONET) derived in this study might be used to determine different levels of crowding in a high volume UCC setting. It also showed that UCC overcrowding might be associated with negative patient care outcomes.

SONET Score=24.5×total patient index+58.1×waiting room patient index+2.7×number of results pending for patients+12.2×the longest time in hours of patient in the waiting room+32.4. (in short form: SONET Score=24.5T +58.1WI+2.7R+12.2L+32.4 (TWIRL), where T indicates the total patients index, WI indicates the waiting room patient index, R indicates the number of results pending for patients in a UCC, and L indicates the longest time in hours of patients in the waiting room). SONET score ≥100 is considered UCC overcrowded and score ≥140 is considered severely overcrowded.