WSC '92 Proceedings of the 24th conference on Winter simulation
A simulation model for evaluating personnel schedules in a hospital emergency department
WSC '96 Proceedings of the 28th conference on Winter simulation
A simulation model for same day care facility at a university hospital
WSC '91 Proceedings of the 23rd conference on Winter simulation
Emergency department simulation and determination of optimal attending physician staffing schedules
Proceedings of the 31st conference on Winter simulation: Simulation---a bridge to the future - Volume 2
The State of the Art of Nurse Rostering
Journal of Scheduling
Simulation analysis of an outpatient department of internal medicine in a university hospital
Proceedings of the 38th conference on Winter simulation
Optimizing staffing schedule in light of patient satisfaction for the whole outpatient hospital ward
Proceedings of the 40th Conference on Winter Simulation
SEHC '09 Proceedings of the 2009 ICSE Workshop on Software Engineering in Health Care
Simulation with data scarcity: developing a simulation model of a hospital emergency department
Proceedings of the Winter Simulation Conference
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The Emergency Room Services (ER) of a hospital is a complex probabilistic system where discrete event simulation can be applied. This paper presents the simulation analysis of the ER at Georgetown University Hospital (GUH), using a unique approach to schedule nursing staff.The analysis was accomplished in three phases as follows:a) Patient Classification system: A patient classification system, consisting of five patient acuity levels, was designed to identify degrees of resource needs by objectively delineating the nursing tasks at each acuity level.b) Data Collection and Data Base: A PC based database was specifically designed to collect ER workload information such as patient arrival time and acuity of patient by hour of the day.c) Modeling and Simulation: The model was designed to be sensitive to hourly patient acuity mix levels, since the workload in the ER is primarily dictated by this.The simulation was conducted using SIMAN, a PC based language for a period of 1,000 hours. The first 120 hours of the simulation run were ignored to allow the system to reach steady state. Upon arrival the patients were assigned an acuity, triaged and based on acuity sent either directly to the treatment area or to registration and then treatment area.In the treatment area a patient was seen every hour by the nurse staff till the length of stay was completed. The number of nurses and amount of direct nursing care provided to a patient depended upon the acuity level.Auxiliary patient care such as nurses accompanying a patient to the CT SCAN unit was also incorporated into the model after the treatment block. The auxiliary care parameters were based on probabilities derived from the database.The current schedule was first simulated to validate the model by comparing simulation output with real time data. Ten different types of schedules such as all 8 hour shifts or all 12 hour shifts with lesser number of staff were simulated to examine the impact these schedules had on the ER patient workload.The primary outputs of the SIMAN simulation reports were; patient wait time prior to being seen in the treatment area, patient queue lengths in the waiting area and staff utilization by time of day. .Based on the simulation experiments a feasible cost effective schedule consisting of 12 hours shift is being implemented. The Information System designed in Phase II is now being integrated with the Hospital Information Systems ER Log to provide periodic decision support reports to the ER managers.