Hospital Emergency Department Simulation for Resource Analysis

  • Kozan, Erhan (School of Mathematical Sciences Queensland University of Technology) ;
  • Diefenbach, Mel (School of Mathematical Sciences Queensland University of Technology)
  • 발행 : 2008.09.30

초록

The Emergency Department (ED) is an integral part of hospitals. Admissions from the ED account for a significant proportion for a hospital's activity. Ensuring a timely and efficient flow of patients through the ED is crucial for optimising patient care. In recent years, ED overcrowding and its impact on patient flow has become a major issue facing the health sector. Simulation is rapidly becoming a tool of choice when examining hospital systems due to its capacity to involve numerous factors and interactions that impact the system. An analytical simulation model is used to investigate potential impacts by changing the following aspects of ED (physical layouts; number of beds; number and rate of patient arrivals; acuity of illness or injury of patients; access to radiology and pathology services; hospital staffing arrangements; and access to inpatient beds). Results of a significant numerical investigation at a hospital are also presented.

키워드

참고문헌

  1. Australasian College for Emergency Medicine (ACEM) (2000), The Australasian triage scale, www.acem. org.au/open/documents/triage.htm.
  2. Australasian College for Emergency Medicine (ACEM) (2001), Standard terminology, www.acem.org.au/op en/documents/standard.pdf.
  3. Australasian College for Emergency Medicine (ACEM), (1998), Emergency department design guidelines, www.acem.org.au/open/documents/ed design.
  4. Alessandra A. J., Grazman T. E., Parameswaran R. and Yavas U. (1978), Using Simulation in Hospital Planning, Simulation, 30(2), 62-67. https://doi.org/10.1177/003754977803000206
  5. Badri M. A. and Hollingsworth J. (1993), A Simulation Model for Scheduling in the Emergency Room, International Journal of Operations and Production Management, 13, 13-24. https://doi.org/10.1108/01443579310025989
  6. Bagust, A., Place, M. and Posnett, J. W. (1999), Dynamics of bed use in accommodating emergency admissions: stochastic simulation model, BMJ, 319, 155- 158. https://doi.org/10.1136/bmj.319.7203.155
  7. Barnard, A., (2002), Study Ties Crowded Emergency Rooms to Surgeons' Schedules, Boston Globe, Boston.
  8. Blake J. T., Carter M. W. and Richardson S. (1996), An Analysis of Emergency Wait Times Issues via Computer Simulation, INFOR 1996, 34, 263-273.
  9. Connelly, L. G. and Bair, A. E. (2004), Discrete event simulation of emergency department activity: A platform for system-level operations research, Academic Emergency Medicine, 11(11), 1177-1185. https://doi.org/10.1111/j.1553-2712.2004.tb00702.x
  10. Cote M. J. (1999), Patient Flow and Resource Utilisation in an Outpatient Clinic, Socio-Economic Planning Sciences, 33, 231-245. https://doi.org/10.1016/S0038-0121(99)00007-5
  11. Department of Health and Ageing (2005), The state of our public hospitals, http://www.health.gov.au/internet/ wcms/publishing.nsf/Content/health-ahca-sooph.
  12. Estey, A., Ness, K., Saunders, L. D., Alibhai, A. and Bear, R. A. (2003), Understanding the causes of overcrowding in emergency departments in the capital health region in Alberta, Canadian Journal of Emergency Medicine, 5(2).
  13. Extend_6, (2002), http://www.imaginethatinc.com.
  14. Gonzalez-Martinez, M., Borges, J. A., Navarro, J. and Rodriguez, N. J. (1997), An automatic resource scheduling system (ARSS), Computers and Industrial Engineering, 33, 295-298. https://doi.org/10.1016/S0360-8352(97)00096-X
  15. Gove D. and Hewett D. (1995), A Hospital Capacity Planning Model, OR Insight, 8(2), 12-14. https://doi.org/10.1057/ori.1995.8
  16. Hancock W. M., Magerlain D. B, Storer R. H. and Martin J. B. (1978), Parameters Affecting Hospital Occupancy and Implications for Facility Sizing, Health Services Research, 13, 276-289.
  17. Huang X. M., Taylor C. and Stewart I. (1995), Computer Simulation of A&E Department, OR Insight, 8(2), 18-23. https://doi.org/10.1057/ori.1995.10
  18. Hughes, M., Carson, E., Morgan, C. and Silvester, P. (2005), Evaluating control in a surgical progressive-care system, Control Engineering Practice, 13(9), 1123-1128. https://doi.org/10.1016/j.conengprac.2004.12.001
  19. Kao E. P. C. and Tung G. G. (1981), Bed Allocation on a Public Health Care Delivery System, Management Science, 27, 507-520. https://doi.org/10.1287/mnsc.27.5.507
  20. Knox, D. I. (2004), Australia's emergency departments "at or over maximum capacity", a real emergency, www.acem.org.au/.
  21. Kozan, E. and Gillingham, S.(1997), An Application of a Simulation Model to the Maternity Ward System of the Wesley Hospital, International Congress on Modelling and Simulation, 4, 1035-1041, Australia.
  22. Landro, L. (2001), Emergency rooms hope new technology will ease their trauma, Wall Street Journal, 13, July, B1.
  23. McClean S. and Millard P. H. (1995), A Decision Support System for Bed-occupancy Management and Planning Hospitals, IMA Journal of Mathematics Applied in Medicine and Biology, 12, 249-257. https://doi.org/10.1093/imammb/12.3-4.249
  24. McHardy S., Kozan E. and Cook D. (2004), Modelling of Intensive Care Units and Operating Theatre in Public Hospitals, The Fifth Asia-Pacific Industrial Engineering and Management Systems Conference, 13. 3.1-13.3.18, Australia.
  25. McHardy S., Kozan. E. and Cook. D. (2005), Robust Reactive Scheduling Model as Applied to a Public Hospital ICU, Proceedings of the 18th National Australian Society for Operations Research and 11th Australian Optimisation, 75-81.
  26. Nozar, R. A. (2003), The impact of EMRs can be felt right at the patient's bedside, Managed Healthcare Executive, 13(9), 48-49.
  27. NSW Health (2001), Shared responsibility for patient care between hospitals and the community: an effective discharge policy, www.health.nsw.gov.au/policy/gap/ publications/pdf/dischpolicy.pdf.
  28. Pidd M. (1996), Tools for Thinking: Modelling in Management Science, John Wiley and Sons, West Sussex.
  29. Sarver, J. H., Cydulka, R. K. and Baker, D. W. (2002), Usual source of care and nonurgent emergency department use, Academic Emergency Medicine, 9(9), 916.
  30. Schriver, J. A., Talmadge, R., Chuong, R. and Hedges, J. R. (2003), Emergency nursing: Historical, current, and future roles', Journal of Emergency Nursing, 29(5), 431-439. https://doi.org/10.1016/S0099-1767(03)00346-5
  31. Vasssilacopoulos G. (1985), A Simulation Model for Bed Allocation to Hospital Inpatient Departments, Simulation, Nov, 233-241.
  32. Wellness Institute (2005), The evolving role of emergency, http://www.wellnessinstitute.mb.ca/news/articles/evo lvingemerg 1004.php.