Discrete simulation application-scheduling staff for the emergency room

Kumar, Arun; Kapur, Rajiv

doi:10.1145/76738.76880

Cited by 30 publications

(19 citation statements)

References 1 publication

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“…Discrete event simulation modelling has been used for at least three decades to study staffing and scheduling decisions in clinics, hospitals and EDs 11 13 17–19. More recently, discrete event simulation has been suggested as a method to predict the system impacts of QI projects and guide ongoing improvement efforts 10.…”

Section: Discussionmentioning

confidence: 99%

Discrete event simulation modelling to evaluate the impact of a quality improvement initiative on patient flow in a paediatric emergency department

et al. 2020

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ObjectiveWe developed a discrete event simulation model to evaluate the impact on system flow of a quality improvement (QI) initiative that included a time-specific protocol to decrease the time to antibiotic delivery for children with cancer and central venous catheters who present to a paediatric ED with fever.MethodsThe model was based on prospective observations and retrospective review of ED processes during the maintenance phase of the QI initiative between January 2016 and June 2017 in a large, urban, academic children’s hospital in New York City, USA. We compared waiting time for full evaluation (WT) and length of stay (LOS) between a model with and a model without the protocol. We then gradually increased the proportion of patients receiving the protocol in the model and recorded changes in WT and LOS.ResultsWe validated model outputs against administrative data from 2016, with no statistically significant differences in average WT or LOS for any emergency severity index (ESI). There were no statistically significant differences in these flow metrics between the model with and the model without the protocol. By increasing the proportion of total patients receiving this protocol, from 0.2% to 1.3%, the WT increased by 2.8 min (95% CI: 0.6 to 5.0) and 7.6 min (95% CI: 2.0 to 13.2) for ESI 2 and ESI 3 patients, respectively. This represents a 14.0% increase in WT for ESI 3 patients.ConclusionsSimulation modelling facilitated the testing of system effects for a time-specific protocol implemented in a large, urban, academic paediatric ED, showing no significant impact on patient flow. The model suggests system resilience, demonstrating no detrimental effect on WT until there is a 7-fold increase in the proportion of patients receiving the protocol.

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Section: Discussionmentioning

confidence: 99%

Discrete event simulation modelling to evaluate the impact of a quality improvement initiative on patient flow in a paediatric emergency department

et al. 2020

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“…Just as medical and other devices should be tested under actual conditions of expected use, health care systems would be expected to benefit from pilot‐testing and troubleshooting activities. Examples of previous acute care systems improvement efforts utilizing computational simulation (CS) 30–65 and physical simulation (PS) 66–86 are listed in Tables 2 and 3.…”

Section: Application Of Quality Management and Human Factors Principlmentioning

confidence: 99%

Advanced Medical Simulation Applications for Emergency Medicine Microsystems Evaluation and Training

Kobayashi

Overly

Fairbanks

et al. 2008

Academic Emergency Medicine

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Participants in the 2008 Academic Emergency Medicine Consensus Conference ''The Science of Simulation in Healthcare: Defining and Developing Clinical Expertise'' morning workshop session on developing systems expertise were tasked with evaluating best applications of simulation techniques and technologies to small-scale systems in emergency medicine (EM). We collaborated to achieve several objectives: 1) describe relevant theories and terminology for discussion of health care systems and medical simulation, 2) review prior and ongoing efforts employing systems thinking and simulation programs in general medical sectors and acute care medicine, 3) develop a framework for discussion of systems thinking for EM, and 4) explore the rational application of advanced medical simulation methods to a defined framework of EM microsystems (EMMs) to promote a ''quality-by-design'' approach. This article details the materials compiled and questions raised during the consensus process, and the resulting simulation application framework, with proposed solutions as well as their limitations for EM systems education and improvement. ACADEMIC EMERGENCY MEDICINE 2008; 15:1058-1070 ª 2008 by the Society for Academic Emergency MedicineKeywords: emergency medicine, health services research, health care evaluation mechanisms, simulation, systems analysis, systems theory A ctivities of large organizations can be viewed and studied as the product of highly connected, dynamic, and interdependent groups exhibiting emergent properties, i.e., systems. Application of this framework as a problem-solving approach to contextualize institutions; explore the hierarchies and interactions

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“…Several other simulation models were also developed in the area of EMS. Later, Kumar and Kapur [8] performed a simulation analysis for the emergency room at Georgetown University Hospital using the simulation approach to schedule nursing staff.…”

Section: Literature Reviewmentioning

confidence: 99%

Simulation Analysis of Army Casualty Evacuations

Nuhut¹,

Sabuncuoğlu

2002

SIMULATION

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Since war games and field exercises are very expensive, mathematical models are often developed to analyze military systems. In this study, the authors investigate a brigade casualty evacuation system (BCES) via simulation. Specifically, they model the existing BCES of the Turkish Army and analyze the system to improve the patient flow processes in main facilities. The proposed model aims to provide the necessary information to the commanders in a maneuver, logistics, and medical unit about casualties such as time in medical facilities, waiting times in doctor queues, utilization of doctors, and percentages of casualties who return to duty or are sent to higher level medical facilities. The simulation model is also used to compare several alternative system designs and evaluate their impacts on system performance. The result of this study highlights the major problem areas of the system and the possible ways to deal with them.

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Discrete simulation application-scheduling staff for the emergency room

Cited by 30 publications

References 1 publication

Discrete event simulation modelling to evaluate the impact of a quality improvement initiative on patient flow in a paediatric emergency department

Discrete event simulation modelling to evaluate the impact of a quality improvement initiative on patient flow in a paediatric emergency department

Advanced Medical Simulation Applications for Emergency Medicine Microsystems Evaluation and Training

Simulation Analysis of Army Casualty Evacuations

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