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Development of emergency department load relief area--gauging benefits in empirical terms

Authors
 Farrukh Rasheed  ;  Young Hoon Lee  ;  Seung Ho Kim  ;  In Cheol Park 
Citation
 SIMULATION IN HEALTHCARE-JOURNAL OF THE SOCIETY FOR SIMULATION IN HEALTHCARE, Vol.7(6) : 343-352, 2012 
Journal Title
 SIMULATION IN HEALTHCARE-JOURNAL OF THE SOCIETY FOR SIMULATION IN HEALTHCARE 
ISSN
 1559-2332 
Issue Date
2012
MeSH
Computer Simulation ; Crowding ; Efficiency, Organizational ; Emergency Service, Hospital/manpower ; Emergency Service, Hospital/organization & administration* ; Emergency Service, Hospital/statistics & numerical data ; Hospitals, University/organization & administration ; Hospitals, University/statistics & numerical data ; Hospitals, Urban/organization & administration ; Hospitals, Urban/statistics & numerical data ; Humans ; Length of Stay ; Models, Organizational ; Patient Admission/standards ; Patient Admission/statistics & numerical data ; Patient Discharge/standards ; Patient Discharge/statistics & numerical data ; Patient Transfer/organization & administration* ; Patient Transfer/standards ; Patient Transfer/statistics & numerical data ; Quality Assurance, Health Care/methods ; Quality Assurance, Health Care/organization & administration* ; Quality Assurance, Health Care/standards ; Severity of Illness Index ; Time Factors ; Trauma Severity Indices ; Triage/methods* ; Triage/organization & administration ; Triage/standards
Keywords
Health care operation management ; Emergency department ; Crowding ; Discrete-event simulation ; Innovative process approach
Abstract
INTRODUCTION: The primary goal of this investigation was to develop a simulation model to evaluate the various internal and external factors affecting patient flow and crowding in the emergency department (ED). In addition, a few recommendations are proposed to reconfigure the patient flow to improve ED capacity while maintaining service quality. METHODS: In this research, we present a simulation study conducted in the ED at the "S Hospital" located in Seoul. Based on patient flow data and process analysis, a simulation model of patient throughput in the ED has been developed. We evaluated simulations of diverting the specific patient load in the light of our proposed recommendations to a separately managed area named as the ED load relief area (ED-LRA) and analyzing potential effects on overall length of stay (LOS) and waiting time (WT). RESULTS: What-if analyses have been proposed to identify key issues and investigate the improvements as per our proposed recommendations. The simulation results suggest that specific patient load diversion is needed to ensure desired outcomes. With the diversion of specific patient load to ED-LRA, there is a reduction of 40.60% in mean LOS and 42.5% in WT with improved resource utilization. As a result, opening of an ED-LRA is justified. CONCLUSIONS: Real-world systems are often too intricate for analytical models and often too expensive to trial with directly. Simulation models allow the modeling of this intricacy and enable experimentation to make inferences about how the actual system might perform. Our simulation study modeled that diverting the specific patient load to ED-LRA produced an improvement in overall ED's LOS and WT.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=01266021-201212000-00004&LSLINK=80&D=ovft
DOI
22960699
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seung Ho(김승호)
Park, In Cheol(박인철) ORCID logo https://orcid.org/0000-0001-7033-766X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91852
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