Improving the Efficiency of an Emergency Department Based on Activity-Relationship Diagram and Radio Frequency Identification Technology

Weng, Shao-Jen; Tsai, Mi Ching; Tsai, Yao-Te; Gotcher, Donald F.; Chen, Chih‐Hao; Liu, Shih‐Chia; Xu, Yeong-Yuh; Kim, Seunghwan

doi:10.3390/ijerph16224478

Cited by 8 publications

(8 citation statements)

References 34 publications

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“…Represents M (M − 1)/2 symmetric qualitative relationships, where M is the number of spaces in the department layout. The degree of this relationship can be described using the AEIOUX rating 26 , 27 . Table 1 depicts the proposed REL chart of each department using the AEIOUX rating system according to international standards, as shown in Algorithm 2.…”

Section: Methodsmentioning

confidence: 99%

Evaluating building performance in healthcare facilities using entropy and graph heuristic theories

Hassanain

Eldosoky

Soliman

2022

Sci Rep

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Designing a healthcare facility is one of the most challenging tasks due to the complexity associated with these facilities. The primary goal of healthcare facilities is to provide high-quality care; consequently, the design of healthcare facilities and their environments directly affects the facility's productivity, the organization's economic performance, the experienced clinical outcomes in the hospital, as well as patient and staff satisfaction. The redesign of a healthcare facility is essential for ensuring a serene healing environment for the patients and thus influences their healing rates, reduces the amount of time spent in the facilities, and impacts their level of satisfaction with the care provided. The evaluation methodology is a step in the redesign process that measures the performance of healthcare buildings according to international standards. In this study, the collected standards were weighted using an entropy algorithm to evaluate different departments in various hospitals. In addition, the layout score was measured using the adjacent algorithm as one of the graph heuristic methods to determine whether the department or the whole hospital can be redesigned to meet international standards. According to the results of our methodologies being used in one selected hospital in Egypt, the average of the satisfied standards was 43%, standards that could be satisfied were 24%, not applicable standards were 34%, and the average layout score was 25.

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Section: Methodsmentioning

confidence: 99%

Evaluating building performance in healthcare facilities using entropy and graph heuristic theories

Hassanain

Eldosoky

Soliman

2022

Sci Rep

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“…In some studies, DES and other techniques were used together to simulate nurse mobility and establish relationships between various departments. 36,37…”

Section: Literature Reviewmentioning

confidence: 99%

Evaluating Different Strategies on the Blood Collection Counter Settings to Improve Patient Waiting Time in Outpatient Units

Chen

Tsai

Chou

et al. 2022

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Long patient waiting time is one of the major problems in the healthcare system and it would decrease patient satisfaction. Previous studies usually investigated how to improve the treatment flow in order to reduce patient waiting time or length of stay. The studies on blood collection counters have received less attention. Therefore, the objective of this study is to reduce the patient waiting time at outpatient clinics for metabolism and nephrology outpatients. A discrete-event simulation is used to analyze the four different strategies for blood collection counter resource allocation. Through analyzing four different strategic settings, the experimental results revealed that the maximum number of patients waiting before the outpatient clinics was reduced from 41 to 33 (20%); the maximum patient waiti-ng time at the outpatient clinics was decreased from 201.6 minutes to 83 minutes (59%). In this study, we found that adjusting the settings of blood collection counters would be beneficial. Assigning one exclusive blood collection counter from 8 to 10 am is the most suitable option with the least impact on the operational process for hospital staff. The results provide managerial insight regarding the cost-effective strategy selection for the hospital operational strategy.

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“…[1][2][3][4] Many solutions have been proposed to help alleviate ED crowding, including physical improvements, such as increasing the number of physicians and nurses; technological improvements, such as improving the electronic medical records system; and process improvements, such as using a team triage model. 5,6 This study concentrates on the team triage model, which has been known to be beneficial in reducing ED crowding. In this study, we focus on whether team triage results in over-ordering and decreases diagnostic yield of the tests being ordered.…”

Section: Background and Importancementioning

confidence: 99%

Team triage increases discharges and decreases time to discharge without increasing test ordering

et al. 2021

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Objectives Emergency department (ED) crowding is detrimental to patients and staff. During traditional triage, nurses evaluate patients and identify their level of emergency. During team triage, physicians and/or nurse practitioners (NPs) and physician assistants (PAs) place orders, laboratory results, intravenous lines (IVs), and imaging in triage. Team triage improves access to testing and decreases length of stay. However, ordering practices in team triage may lead to overtesting. Methods This is a retrospective review of patients seen before and after a team triage process was established. Percentage of patients receiving testing and the diagnostic yields of troponins, lactates, international normalized ratios (INRs), blood cultures, glomerular filtration rates (GFR), and head computed tomography (CT) images were studied. Results A total of 704 traditionally triaged patients and 862 team triaged patients met inclusion criteria. Comparing traditional versus team triaged patients, the proportion of patients discharged was 0.44 versus 0.53 ( P < 0.001), and the length of stay to discharge was 417 versus 375 minutes ( P = 0.003). Comparing traditional versus team triage, a head CT was obtained 12.5% versus 5.7% ( P < 0.001) of the time with diagnostic yield 45.5% versus 52% (not significant), troponin was obtained 51.3% versus 45.9% (not significant) of the time with diagnostic yield 14.9% versus 13.9% (not significant), lactate was obtained 41.6% versus 32.1% ( P = 0.011) of the time with diagnostic yield 18.4% versus 12.3% (not significant), INR was obtained 70.2% versus 55.8% ( P = 0.007) of the time with diagnostic yield 15.8% versus 10.5% ( P = 0. 042), GFR was obtained 99.3% versus 98.4% (not significant) of the time with diagnostic yield 18.9% versus 13.7% ( P = 0.02), and blood cultures were obtained 23.4% versus 7.3% ( P < 0.001) of the time with diagnostic yield 7.3% versus 9.3% (not significant). Conclusion Compared with traditional triage, the team triage process increased discharges and decreased time to discharge, but did not lead to increased testing or decreased diagnostic yield.

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Improving the Efficiency of an Emergency Department Based on Activity-Relationship Diagram and Radio Frequency Identification Technology

Cited by 8 publications

References 34 publications

Evaluating building performance in healthcare facilities using entropy and graph heuristic theories

Evaluating building performance in healthcare facilities using entropy and graph heuristic theories

Evaluating Different Strategies on the Blood Collection Counter Settings to Improve Patient Waiting Time in Outpatient Units

Team triage increases discharges and decreases time to discharge without increasing test ordering

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