Models for improving patient throughput and waiting at hospital emergency departments.
BACKGROUND
Overcrowding diminishes Emergency Department (ED) care delivery capabilities.


OBJECTIVE
We developed a generic methodology to investigate the causes of overcrowding and to identify strategies to resolve them, and applied it in the ED of a hospital participating in the study.


METHODS
We utilized Discrete Event Simulation (DES) to capture the complex ED operations. Using DES results, we developed parametric models for checking the effectiveness and quantifying the potential gains from various improvement alternatives. We performed a follow-up study to compare the outcomes before and after the model recommendations were put into effect at the hospital participating in the study.


RESULTS
Insufficient physicians during peak hours, the slow process of admitting patients to inpatient floors, and laboratory and radiology test turnaround times were identified as the causes of reduced ED throughput. Addition of a physician resulted in an almost 18% reduction in the ED Main discharged patient length of stay.


CONCLUSIONS
The case study results demonstrated the effectiveness of the generic methodology. The research contributions were validated through statistically significant improvements seen in patient throughput and waiting time at the hospital participating in the study.
Department of Economics, Finance and Quantitative Analysis, Kennesaw State University, Kennesaw, Georgia 30144, USA.
Jomon Aliyas
JA
Paul
Li
L
Lin
D003441:Crowding; D004635:Emergency Medicine; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D007902:Length of Stay; D010561:Personnel Staffing and Scheduling; D013597:Systems Analysis; D014850:Waiting Lists; D000078329:Workforce