Queueing Problems in Emergency Departments: A Review of Practical Approaches and Research Methodologies

Elalouf, Amir; Wachtel, Guy

doi:10.1007/s43069-021-00114-8

Cited by 23 publications

(13 citation statements)

References 207 publications

(178 reference statements)

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“…Therefore, further investigation is warranted to examine whether long waiting times are a problem in Indonesian EDs. 14,15 To achieve this, quantitative evaluations through digital modes are preferable. 16,17 The demand for additional services, namely reservation systems to see a doctor, medical interview applications (e.g., smartphone app), and home visitation services, are high.…”

Section: Discussionmentioning

confidence: 99%

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Survey on emergency care utilization in tertiary care hospitals in Indonesia

Fujisawa,

Fukaguchi,

Tokita

et al. 2024

Preprint

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Objective: Indonesia's emergency care system remains suboptimal despite rising demand due to socio-economic changes and increased life expectancy. This study aims to examine patient and family perceptions of the current emergency care system, identify potential needs, and provide a foundation for its development and improvement. Methods: This cross-sectional study used an online survey at two Indonesian hospitals in 2022 to target adult emergency department patients or their families. Each participant's demographic data, patient journey details, and potential additional medical services were analyzed using descriptive statistics. Results: The study included 446 participants, primarily family members of patients (93.7%), with a median age of 37 (IQR: 28 to 43 years). The majority of patients visited the hospital using private cars (36.9%) and taxis (17.2%), with marked variation between the two hospitals. Only 9.4% of participants were aware of Public Safety Center (PSC) services, and the majority (58.9%) did not use them because they did not know how to contact PSC. The most common waiting time was up to 20 minutes at two tertiary care hospitals. Additional services desired by participants included doctor reservation systems, medical interview applications, and home visitation services. Reported problems included long waiting times and crowded emergency rooms. Conclusions: The study highlights transportation disparities and the demand for supplemental services to better emergency department experiences. For optimizing PSC utilization and future resource distribution, it is vital to further investigate patient behaviors and needs during emergency department visits.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Survey on emergency care utilization in tertiary care hospitals in Indonesia

Fujisawa,

Fukaguchi,

Tokita

et al. 2024

Preprint

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“…The application of computational operational research methods to health care delivery and capacity planning has a long history [25][26][27][28][29]. A recent umbrella review of systematic reviews [30] highlights the diverse range of healthcare applications, including obstetrics [31], radiotherapy [32], surgery [33][34][35], emergency departments [36][37][38], community health care [39] and distribution of blood products [40]. These methods have also previously been applied to challenges arising in the context of a pandemic.…”

Section: Open Accessmentioning

confidence: 99%

Modelling vaccination capacity at mass vaccination hubs and general practice clinics: a simulation study

Hanly

Churches

Fitzgerald

et al. 2022

BMC Health Serv Res

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Background COVID-19 mass vaccination programs place an additional burden on healthcare services. We aim to model the queueing process at vaccination sites to inform service delivery. Methods We use stochastic queue network models to simulate queue dynamics in larger mass vaccination hubs and smaller general practice (GP) clinics. We estimate waiting times and daily capacity based on a range of assumptions about appointment schedules, service times and staffing and stress-test these models to assess the impact of increased demand and staff shortages. We also provide an interactive applet, allowing users to explore vaccine administration under their own assumptions. Results Based on our assumed service times, the daily throughput for an eight-hour clinic at a mass vaccination hub ranged from 500 doses for a small hub to 1400 doses for a large hub. For GP clinics, the estimated daily throughput ranged from about 100 doses for a small practice to almost 300 doses for a large practice. What-if scenario analysis showed that sites with higher staff numbers were more robust to system pressures and mass vaccination sites were more robust than GP clinics. Conclusions With the requirement for ongoing COVID-19 booster shots, mass vaccination is likely to be a continuing feature of healthcare delivery. Different vaccine sites are useful for reaching different populations and maximising coverage. Stochastic queue networks offer a flexible and computationally efficient approach to simulate vaccination queues and estimate waiting times and daily throughput to inform service delivery.

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“…To address the problem of long waits in the emergency department, a hospital implements a fast-track system. Patients with minor illness can go to the "fast-track" area and be treated faster [Meislin et al, 1988, Elalouf andWachtel, 2022]. We think of the patients who go to the "fast-track" area or leave the hospital as choosing the outside option.…”

Section: Introductionmentioning

confidence: 99%

Experimenting under Stochastic Congestion

Li¹,

Johari²,

Wager³

et al. 2023

Preprint

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Stochastic congestion, a phenomenon in which a system becomes temporarily overwhelmed by random surges in demand, occurs frequently in service applications. While randomized experiments have been effective in gaining causal insights and prescribing policy improvements in many domains, using them to study stochastic congestion has proven challenging. This is because congestion can induce interference between customers in the service system and thus hinder subsequent statistical analysis. In this paper, we aim at getting tailor-made experimental designs and estimators for the interference induced by stochastic congestion. In particular, taking a standard queueing system as a benchmark model of congestion, we study how to conduct randomized experiments in a service system that has a single queue with an outside option. We study switchback experiments and a local perturbation experiment and propose estimators based on the experiments to estimate the effect of a system parameter on the average arrival rate. We establish that the estimator from the local perturbation experiment is asymptotically more accurate than the estimators from the switchback experiments because it takes advantage of the structure of the queueing system.

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Queueing Problems in Emergency Departments: A Review of Practical Approaches and Research Methodologies

Cited by 23 publications

References 207 publications

Survey on emergency care utilization in tertiary care hospitals in Indonesia

Survey on emergency care utilization in tertiary care hospitals in Indonesia

Modelling vaccination capacity at mass vaccination hubs and general practice clinics: a simulation study

Experimenting under Stochastic Congestion

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