Emergency department simulation and determination of optimal attending physician staffing schedules

Abstract

Efficient allocation and utilization of staff resources is an important issue facing emergency department (ED) administrators. Increased pressure from competition, heath care reform, reimbursement difficulties, and rising heath care costs are primarily responsible for the high level of interest in this, and other ED operating efficiency issues. This paper discusses the use of computer simulation to test alternative ED attending physicianstaffing schedules and to analyze the corresponding impacts on patient throughput and resource utilization. The simulation model can also be used to help identify process inefficiencies and to evaluate the effects of staffing, layout, resource, and patient flow changes on system performance without disturbing the actual system. The development of this model was based on the

Optimized Workflow for the Healthcare Logistic: Case of the Pediatric Emergency Department

“…It is not a structure but an operative concept. The patient flow can vary from patient to patient based on acuity level and diagnosis [12]. The hospital establishments are chronically confronted to a problematic for which no satisfying answer exists at the present time.…”

“…The model was developed to test alternative ED attending physicianstaffing schedules and to analyze the corresponding impacts on patient throughput and resource utilization [5], to help the ED managers understand the behavior of the system with regard to the hidden causes of excessive waiting times [6], to analyze patient flows and throughput time [7] [8][9] [10]. DES has also been used for estimating future capacities of new ED facilities or expansions [11] [12]. The main objectives of the present paper are: 1) To model the Pediatric Emergency Department (PED) using Workflow Methodology for better understanding the patient flow process through the PED, 2) To simulate using the same tool Workflow in order to identify and analysis the dysfunctions of the PED and also to propose and to estimate prevention indicators of tensions.…”

Simulating patient flow through an Emergency Department using process-driven discrete event simulation

“…A study by Rossetti et. al [14] looked at the use of computer simulation to test alternative ED attending physician-staffing schedules and to analyze the corresponding impacts on patient throughput and resource utilization. A second area of focus in ED simulation studies has been to look at process changes and their impact.…”

Simulation analysis of resident and attending physician teaching methods at Kosair Children's Hospital.

“…There have been many studies in this specific area. For instance, Rossetti, Trzcinski, and Syverud (1999) created four alternative physician schedules in order to compare and determine if improvements could be made. Their best physician schedule that was created decreased the wait time by 13 minutes.…”

“…After the simulation model was completed, the steps of model verification and validation were performed. Rossetti et al (1999) state, "Verification is the process of ensuring that the simulation model is built correctly and performs as the modeler intended," and "Validation is the process of ensuring that the model is an accurate representation of the actual system and behaves in the same way." According to Averill M. Law (2007), there are eight different techniques to verify a simulation model.…”