title: Using Computer Simulation to Study Nurse-to-Patient Ratios in an Emergency Department.
abstract: OBJECTIVE
  To study the impact of nurse-to-patient ratios on patient length of stay (LOS) in computer simulations of emergency department (ED) care.
  
  
  METHODS
  Multiple 24-hour computer simulations of emergency care were used to evaluate the impact of different minimum nurse-to-patient ratios related to ED LOS, which is composed of wait (arrival to bed placement) and bedtime (bed placement to leave bed).
  
  
  RESULTS
  Increasing the number of patients per nurse resulted in increased ED LOS. Mean bedtimes in minutes were impacted by nurse-to-patient ratios.
  
  
  CONCLUSIONS
  In computer simulation of ED care, increasing the number of patients per nurse resulted in increasing delays in care (ie, increasing bedtime).
authors.affiliation: Author Affiliations: Professor and Attending Physician (Dr Henneman) and Assistant Professor and Nurse Research Coordinator (Ms Blank), Department of Emergency Medicine at Tufts University School of Medicine, Baystate Medical Center, Springfield, Massachusetts; PhD Candidate (Mr Shin) and Assistant Professor (Dr Brun), School of Computer Science, and Associate Professor (Dr Balasubramanian), College of Engineering, University of Massachusetts, Amherst; and Professor (Dr Osterweil), School of Computer Science, University of Massachusetts, Amherst.
authors.forename: Philip L
authors.initials: PL
authors.lastname: Henneman
authors.forename: Seung Yeob
authors.initials: SY
authors.lastname: Shin
authors.forename: Yuriy
authors.initials: Y
authors.lastname: Brun
authors.forename: Hari
authors.initials: H
authors.lastname: Balasubramanian
authors.forename: Fidela
authors.initials: F
authors.lastname: Blank
authors.forename: Leon J
authors.initials: LJ
authors.lastname: Osterweil
mesh_terms: D001509:Bed Occupancy / Q000706:statistics & numerical data; D003198:Computer Simulation; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*; D010559:Personnel Management; D058996:Quality Improvement; D014481:United States; D000078329:Workforce