A new medical staff allocation via simulation optimisation for an emergency department in Hong Kong

Chen, Wenjie; Guo, Hainan; Tsui, Kwok‐Leung

doi:10.1080/00207543.2019.1665201

Cited by 23 publications

(31 citation statements)

References 31 publications

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“…The adoption of simulation in EDs is suggested because it reduces disruption in a crucial healthcare service, and the use of this PI approach is encouraged by healthcare scholars and practitioners, alike (e.g. Chen et al, 2020). For example, Ahmed and Alkhamis (2009) described the use of simulation of a system that determines the optimal number of doctors, lab technicians and nurses needed to maximize the yield of the patient and reduce the time of the patient in the health service.…”

Section: Process Improvement Approachesmentioning

confidence: 99%

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Process improvement approaches in emergency departments: a review of the current knowledge

Volochtchuk

Leite

2021

IJQRM

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PurposeThe healthcare system has been under pressure to provide timely and quality healthcare. The influx of patients in the emergency departments (EDs) is testing the capacity of the system to its limit. In order to increase EDs' capacity and performance, healthcare managers and practitioners are adopting process improvement (PI) approaches in their operations. Thus, this study aims to identify the main PI approaches implemented in EDs, as well as the benefits and barriers to implement these approaches.Design/methodology/approachThe study is based on a rigorous systematic literature review of 115 papers. Furthermore, under the lens of thematic analysis, the authors present the descriptive and prescriptive findings.FindingsThe descriptive analysis found copious information related to PI approaches implemented in EDs, such as main PIs used in EDs, type of methodological procedures applied, as well as a set of barriers and benefits. Aiming to provide an in-depth analysis and prescriptive results, the authors carried out a thematic analysis that found underlying barriers (e.g. organisational, technical and behavioural) and benefits (e.g. for patients, the organisation and processes) of PI implementation in EDs.Originality/valueThe authors contribute to knowledge by providing a comprehensive review of the main PI methodologies applied in EDs, underscoring the most prominent ones. This study goes beyond descriptive studies that identify lists of barriers and benefits, and instead the authors categorize prescriptive elements that influence these barriers and benefits. Finally, this study raises discussions about the behavioural influence of patients and medical staff on the implementation of PI approaches.

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Section: Process Improvement Approachesmentioning

confidence: 99%

“…Moreover, these organisational benefits also provide cost reduction and savings in EDs (e.g. Chen et al, 2020;Svirsko et al, 2019). Finally, we present After successful implementation of the process change, a cost-benefit analysis was conducted.…”

Section: Main Barriers To Implement and Sustainmentioning

confidence: 99%

Process improvement approaches in emergency departments: a review of the current knowledge

Volochtchuk

Leite

2021

IJQRM

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“…Moreover, it shows that adding a nurse can reduce the AWT by 25 minutes. Chen et al 48 choose waiting time for physicians (WT) as their objective function and try to reduce that using a DES and a simulated-annealing-based algorithm called ConSA. Ben Othman et al 33 put forward a novel way to allot multi-healthcare tasks that derives from a dynamic ABS.…”

Section: Waiting Time and Overcrowding A Recurring Issue Formentioning

confidence: 99%

Simulation-based optimization methods applied in hospital emergency departments: A systematic review

Yousefi

Fogliatto

2020

SIMULATION

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Since high performance is essential to the functioning of emergency departments (EDs), they must constantly pursue sensible and empirically testable improvements. In light of recent advances in computer science, an increasing number of simulation-based approaches for studying and implementing ED performance optimizations have become available in the literature. This paper aims to offer a survey of these works, presenting progress made on the topic while indicating possible pitfalls and difficulties in EDs. With that in mind, this review considers research studies reporting simulation-based optimization experiments published between 2007 and 2019, covering 38 studies. This paper provides bibliographic background on issues covered, generates statistics on methods and tools applied, and indicates major trends in the field of simulation-based optimization. This review contributes to the state of the art on ED modeling by offering an updated picture of the present state of the field, as well as promising research gaps. In general, this review argues that future studies should focus on increasing the efficiency of multi-objective optimization problems by decreasing their cost in time and labor.

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“…The ED overcrowding problem can be solved in the following three ways: (a) limiting emergency visits (input); (b) increasing the number of discharged/transferred patients and the admission capacity (output), and (c) improving the efficiency of ED flow (throughput) [8]. Much of the existing literature has proposed solving the ED overcrowding problem with the following measures: fast-tracking, reclassification of patient flow, flow improvement of examinations, the participation of physicians in triage, ED flow improvement, simulation-based improvement, and lean management [13,[19][20][21][22][23][24][25][26]. Experts recommend that the single most important factor for ED diversion is the daily variability in the elective surgical caseload [2].…”

Section: Introductionmentioning

confidence: 99%

“…In recent years, simulation-based approaches have been used to answer “what if” questions, in order to achieve more efficient healthcare services [ 31 ]. Due to their complex and stochastic nature, simulation is used as a tool to analyze critical parts of healthcare systems such as facility design (e.g., ED, operating room), staff planning/scheduling, occupancy flows, and bed capacity management [ 26 , 32 , 33 , 34 , 35 ]. Using simulation, a study was done on an ED in a British hospital, with the objective of determining the impact of key resources (such as waiting times, waiting lines, and throughput) [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

Adjusting Daily Inpatient Bed Allocation to Smooth Emergency Department Occupancy Variation

et al. 2020

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Study Objective: Overcrowding in emergency departments (ED) is an increasingly common problem in Taiwanese hospitals, and strategies to improve efficiency are in demand. We propose a bed resource allocation strategy to overcome the overcrowding problem. Method: We investigated ED occupancy using discrete-event simulation and evaluated the effects of suppressing day-to-day variations in ED occupancy by adjusting the number of empty beds per day. Administrative data recorded at the ED of Taichung Veterans General Hospital (TCVGH) in Taiwan with 1500 beds and an annual ED volume of 66,000 visits were analyzed. Key indices of ED quality in the analysis were the length of stay and the time in waiting for outward transfers to in-patient beds. The model is able to analyze and compare several scenarios for finding a feasible allocation strategy. Results: We compared several scenarios, and the results showed that by reducing the allocated beds for the ED by 20% on weekdays, the variance of daily ED occupancy was reduced by 36.25% (i.e., the percentage of reduction in standard deviation). Conclusions: This new allocation strategy was able to both reduce the average ED occupancy and maintain the ED quality indices.

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A new medical staff allocation via simulation optimisation for an emergency department in Hong Kong

Cited by 23 publications

References 31 publications

Process improvement approaches in emergency departments: a review of the current knowledge

Process improvement approaches in emergency departments: a review of the current knowledge

Simulation-based optimization methods applied in hospital emergency departments: A systematic review

Adjusting Daily Inpatient Bed Allocation to Smooth Emergency Department Occupancy Variation

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