New · companion to NEDOCS

The ED Operations Index

A per-facility composite calibrated to your last 90 days. NEDOCS tells you "how bad" against the universal scale. EOI tells you "how stressed this is for this ED" — and flags the moments when those two diverge.

0–100
Continuous index
5
Local bands
6
Z-scored axes
ED Operations Index · local composite Stressed
61
/ 100  ·  NEDOCS = 78
Divergence: EOI is one band ahead of NEDOCS. Look at boarding load and reserve drain — local strain is rising faster than the universal scale shows.
NEDOCS 78 z 0.4 +0.4
Boarding load 812 z 1.6 +1.6
Reserve drain 64 z 1.1 +1.1
Workload (TLX + feel) 58 z 0.9 +0.7
Front-end wait 52 z 0.2 +0.1

One number that knows your ED

A 12-bed critical access hospital and a 110-bed urban Level-1 hit "Stressed" for very different reasons. EOI normalizes against your own trailing 90 days so the band always means the same thing in your language.

Calibrated

Z-scored against your last 90 days

A nightly job recomputes per-axis baselines. Small EDs and large EDs get bands that mean the same thing locally.

Six-axis composite

NEDOCS, boarding, reserve, workload, waits, flags

Each axis is weighted and summed. Weights are tunable per facility from the Settings → Operations Index page.

Show your work

Every contribution is transparent

Open the panel and see raw value, z-score, weight, and contribution for each axis. No black boxes — this is your data, traceable.

Divergence alert

"Looks fine on paper but the floor is on fire"

When EOI runs one or more bands ahead of NEDOCS, the dashboard surfaces the gap. That's usually the leading edge.

NEDOCS-compatible

Never replaces the universal score

EOI sits next to NEDOCS, not in its place. State reporting, peer-review, and benchmarking continue to use NEDOCS as the canonical metric.

Analytics-ready

Persisted alongside every score

EOI snapshots live in the correlation matrix and the analytics views — you can study how it tracks your boarding, LWBS, and feel scores over time.

How EOI is computed

Each axis is z-scored against your hospital's own trailing-90-day distribution. The weighted sum is centered at 50 and scaled so the typical local operational range maps to 0–100. An operational-flag penalty is added on top when diversion, surgery-hold, or incident-command flags are active.

Default weights give equal full weight to NEDOCS, boarding, and reserve; subjective signals (workload, wait) are damped slightly because they have higher per-shift variance. Every weight is tunable per facility.

# Inputs (per shift, against your 90-day baseline) z_nedocs = (current.score − μ_nedocs) / σ_nedocs z_boarding = (longest_admit × admits − μ_boarding) / σ_boarding z_reserve_inv = (100 − reserve_capacity − μ_reserve_inv) / σ_reserve_inv z_workload = (tlx + feel composite − μ_workload) / σ_workload z_wait = (door + mse + last_bed − μ_wait) / σ_wait # Composite weighted = w₁·z_nedocs + w₂·z_boarding + w₃·z_reserve_inv + w₄·z_workload + w₅·z_wait EOI = clamp(0..100, 50 + 12 · weighted + flag_penalty)

Five local bands

Deliberately named differently from NEDOCS so no one mentally collapses them.

Steady

0–25

Operating within local norm.

Elevated

26–45

Above baseline; one watch item appearing.

Stressed

46–65

Multiple axes elevated; brief recommended.

Critical

66–85

Surge actions running; level-loading on the table.

Saturated

86–100

Full local exhaustion of reserves.

Common questions

Does EOI replace NEDOCS?

No. EOI is a companion local composite. State HAvBED, EMResource, ENA validation, and all academic literature continue to use NEDOCS as the canonical metric. EOI gives your facility a calibrated signal on top.

How long does calibration take?

EOI needs ~50 paired (score, context) samples in the trailing 90 days before it can z-score your facility. While calibrating it surfaces NEDOCS itself with a "calibrating" badge — no premature numbers. Most hospitals reach calibration in 2–3 weeks of normal shift cadence.

Can I change the weights?

Yes. Hospital managers can tune component weights from Settings → Operations Index. You can also disable the EOI tile entirely if you want to evaluate without showing it on the dashboard.

Is EOI shared with state agencies?

Only when you explicitly grant it. EOI is one of the optional fields in the per-agency sharing scope (see the integrations page). When granted, agencies receive the band only — not the raw axis values.

Where does the data come from?

The same NEDOCS inputs you already capture, plus the optional context modifiers (downstream beds, staffing, ESI mix, waits, charge feel score, and NASA-TLX). Nothing leaves your facility unless you grant it.

See EOI on your own ED data

Calibration starts the moment you stand up your hospital. Within a few weeks of normal scoring cadence, EOI is reading your floor in your own terms.

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