Resource management and process change in a simplified model of the emergency department

Authors:
Ekkehard Beck;Hari Balasubramanian;Philip L. Henneman
Affiliations:
University of Massachusetts, Amherst, MA;University of Massachusetts, Amherst, MA;Baystate Health, Springfield, MA
Venue:
Winter Simulation Conference
Year:
2009

Citing 8
Cited 0

Using simulation to reduce length of stay in emergency departments

WSC '94 Proceedings of the 26th conference on Winter simulation
Reducing time in an emergency room via a fast-track

WSC '95 Proceedings of the 27th conference on Winter simulation
Emergency departments I: the use of simulation and design of experiments for estimating maximum capacity in an emergency room

Proceedings of the 35th conference on Winter simulation: driving innovation
Emergency departments I: the use of simulation to reduce the length of stay in an emergency department

Proceedings of the 35th conference on Winter simulation: driving innovation
Emergency departments I: using simulation in the architectural concept phase of an emergency department design

Proceedings of the 35th conference on Winter simulation: driving innovation
Functional analysis for operating emergency department of a general hospital

WSC '04 Proceedings of the 36th conference on Winter simulation
Modeling and Improving Emergency Department Systems using Discrete Event Simulation

Simulation
Improving patient flow in a hospital emergency department

Proceedings of the 40th Conference on Winter Simulation

Quantified Score

Hi-index	0.00

Visualization

Abstract

Using a simplified model of an emergency department (ED), we illustrate a 2-step methodology for determining the optimal mix of resources (beds, clerks, triage nurses, registered nurses, and physicians) for different arrival rates. These arrival rates cover the range of annual visit volumes typically observed in EDs in the United States. We also use the model to test a widely recommended process change in EDs: bedside registration. Rather than perform registration immediately after triage, registration is now performed only after the patient is placed in an ED bed and assessed by a nurse and physician. Our results show that bedside registration is efficient only when sufficient beds are available; when an ED is crowded and bed availability is low it actually leads to an increased length of stay. We view our model as a first step in the development of a more elaborate, multiple-acuity ED model.