Modeling and analysis of business process reengineering strategies for improving emergency department efficiency

Srinivas, Sharan; Nazareth, Roland; Ullah, Shoriat

doi:10.1177/0037549720957722

Cited by 22 publications

(16 citation statements)

References 49 publications

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“…There are numerous simulation articles that deal with modeling a specific unit of a healthcare facility, such as the OPD, IPD, ED, etc. More details regarding single unit simulations are available in the following articles on: (a) EDs, 30–34 (b) inpatient facilities, 35–37 and (c) outpatient clinics. 38–40…”

Section: Background and Literature Reviewmentioning

confidence: 99%

Simulation modeling and analysis of primary health center operations

Mohd

Ramamohan

2021

SIMULATION

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We present discrete-event simulation models of the operations of primary health centers (PHCs) in the Indian context. Our PHC simulation models incorporate four types of patients seeking medical care: outpatients, inpatients, childbirth cases, and patients seeking antenatal care. A generic modeling approach was adopted to develop simulation models of PHC operations. This involved developing an archetype PHC simulation, which was then adapted to represent two other PHC configurations, differing in numbers of resources and types of services provided, encountered during PHC visits. A model representing a benchmark configuration conforming to government-mandated operational guidelines, with demand estimated from disease burden data and service times closer to international estimates (higher than observed), was also developed. Simulation outcomes for the three observed configurations indicate negligible patient waiting times and low resource utilization values at observed patient demand estimates. However, simulation outcomes for the benchmark configuration indicated significantly higher resource utilization. Simulation experiments to evaluate the effect of potential changes in operational patterns on reducing the utilization of stressed resources for the benchmark case were performed. Our analysis also motivated the development of simple analytical approximations of the average utilization of a server in a queueing system with characteristics similar to the PHC doctor/patient system. Our study represents the first step in an ongoing effort to establish the computational infrastructure required to analyze public health operations in India and can provide researchers in other settings with hierarchical health systems, a template for the development of simulation models of their primary healthcare facilities.

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Section: Background and Literature Reviewmentioning

confidence: 99%

Simulation modeling and analysis of primary health center operations

Mohd

Ramamohan

2021

SIMULATION

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“…The model was solved deterministically at small scales; however, at large scales, it was solved using a simulation-based optimization method along with a simulated annealing algorithm. Srinivas et al 68 aimed to mitigate the problem of congestion and uneven distribution of the workload in the medical centers of the state of Missouri, USA, which they attribute to high demand and insufficient human resources. The authors developed a bi-objective DES model to explore alternate solutions for the triage process, workforce planning, and capacity expansion.…”

Section: Literature Reviewmentioning

confidence: 99%

Location and hierarchical allocation disaster with combined ε-constraint and simulation-based optimization approach

et al. 2021

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The increasing frequency of natural disasters and the necessity of proper planning to minimize the impact and casualties of such crises have always been matters of great concern to human societies. In this study, a hybrid mathematical-simulative location-allocation model is proposed to carry out disaster management (DM) efforts with maximum coverage in the immediate aftermath of an earthquake. The proposed model consists of two phases: determining the optimal location of the temporary emergency stations (TECs), followed by optimal and hierarchical allocation of casualties to said temporary medical centers (TMCs). Given the contradictory nature of the model’s two objectives, that is, minimizing the cost of setting up TMCs and the time taken to transfer casualties to TMC. In the second phase, a simulation-based optimization approach is employed to simulate casualties’ behavior at the onset of the disaster and to determine the optimal capacity of the medical centers. The findings indicate that the costs and distance traveled by casualties during the earthquake have been reduced by 15%.

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“…In addition, since simulation models can be usefully employed as explanatory tools to define a system or problem; analysis means to identify critical components; good assessors of design to consider and evaluate possible solutions; sound tool to predict and assist any planning for any potential development; helpful vehicles to study and analyze systems of interest in the design phase, before the systems are developed; and useful means to experiment with new policies or designs before realization, analyses of this study are placed upon results of simulating the stochastic behavior of the system. [19][20][21][22][23][24][25][26][27][28] Therefore, this study utilizes simulation study to just clarify the importance of design type for architecture of a concerned system in diminishing the processes time and resources utilization significantly.…”

Section: Introductionmentioning

confidence: 99%

Effect of applying independence axiom of Axiomatic Design theory on performance of an Integrated Manufacturing Information System: a computer simulation modeling approach

et al. 2022

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To control manufacturing processes, integration of flows of manufacturing information is an important starting point. In this regard, an effective Integrated Manufacturing Information System (IMIS) which is capable of monitoring, analyzing, and inspecting manufacturing processes properly is critical. Often, most of difficulties in achieving an effective IMIS stem from a poor design for the system architecture. This study particularly addresses the problem of coupling in architecture of an IMIS and its effect on the system performance. This study employs “Independence Axiom” of the Axiomatic Design (AD) theory to deal with the problem and uses “times in process” and “utilized capacities of available resources” as two important criteria for evaluating the system performance. To verify the proposed methodology, a real IMIS is addressed, its stochastic behavior is simulated in Visual SLAM and AweSim (version 3.o) software environment, and the outcomes are analyzed by using logistic regression method for each level of system decomposition. Results of the analyses indicate that fulfillment of independence axiom of AD theory can significantly enhance performance of the concerned IMIS.

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Modeling and analysis of business process reengineering strategies for improving emergency department efficiency

Cited by 22 publications

References 49 publications

Simulation modeling and analysis of primary health center operations

Simulation modeling and analysis of primary health center operations

Location and hierarchical allocation disaster with combined ε-constraint and simulation-based optimization approach

Effect of applying independence axiom of Axiomatic Design theory on performance of an Integrated Manufacturing Information System: a computer simulation modeling approach

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