Reducing time in an emergency room via a fast-track

Garcia, Marelys L.; Centeno, Martha A.; Rivera, Camille; DeCario, Nina

doi:10.1145/224401.224771

Cited by 33 publications

(13 citation statements)

References 2 publications

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“…Previous studies saw a reduction in wait times of approximately 20–25 percent [18, 23], while ours saw a greater reduction which may be due to differences in patient population. Additionally, our model had the additional ability to evaluate nursing resource demand based on patient acuity, which those models did not analyze beyond bed capacity.…”

Section: Discussioncontrasting

confidence: 49%

A Queue-Based Monte Carlo Analysis to Support Decision Making for Implementation of an Emergency Department Fast Track

Fitzgerald

Pelletier

Reznek

2017

Journal of Healthcare Engineering

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Emergency departments (EDs) are seeking ways to utilize existing resources more efficiently as they face rising numbers of patient visits. This study explored the impact on patient wait times and nursing resource demand from the addition of a fast track, or separate unit for low-acuity patients, in the ED using a queue-based Monte Carlo simulation in MATLAB. The model integrated principles of queueing theory and expanded the discrete event simulation to account for time-based arrival rates. Additionally, the ED occupancy and nursing resource demand were modeled and analyzed using the Emergency Severity Index (ESI) levels of patients, rather than the number of beds in the department. Simulation results indicated that the addition of a separate fast track with an additional nurse reduced overall median wait times by 35.8 ± 2.2 percent and reduced average nursing resource demand in the main ED during hours of operation. This novel modeling approach may be easily disseminated and informs hospital decision-makers of the impact of implementing a fast track or similar system on both patient wait times and acuity-based nursing resource demand.

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Section: Discussioncontrasting

confidence: 49%

A Queue-Based Monte Carlo Analysis to Support Decision Making for Implementation of an Emergency Department Fast Track

Fitzgerald

Pelletier

Reznek

2017

Journal of Healthcare Engineering

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“…Mc-Guire (1998) uses Weibull distribution for service times. The majority of service times in Garcia et al (1995) followed a uniform distribution.…”

Section: Data Collectionmentioning

confidence: 97%

“…A number of case studies have been performed on A&E units. Garcia et al (1995) proposed using simulation to look into the possibility of reducing time in an emergency room via a fast track. In another simulation study, McGuire (1998) suggests employing an extra patient care co-ordinator during peak hours, having an alternative room for admitted patients and a fast track to improve the length of stay in the emergency department.…”

Section: Introductionmentioning

confidence: 99%

Modelling patient arrivals when simulating an Accident and Emergency Unit

Meng

Spedding

2008

2008 Winter Simulation Conference

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This paper presents a case study of a discrete event simulation model of an Accident and Emergency Unit in a hospital in the UK. The objective of the study is to create a simulation study of the A&E Unit, to evaluate alternative scenarios and hence reducing patient waiting time. The case study uses a novel approach to predict the arrival time of patients and hence results in a more realistic platform on which to base the subsequent scenario analysis. The scenario analysis illustrates that significant reductions in the waiting time of patients can be obtained by relatively minor changes in operations.

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“…The patient flow and the throughput time were analyzed inside emergency departments (Garcia, Centeno, and DeCario 1995;Mahapatra et al 2003;McGuire 1994;Samaha, Armel, and Starks 2003). In addition, the issues of scheduling the emergency-department staff were treated for analysis, and were reported in several studies (Centeno et al 2003;Draeger 1992;Evans, Gor, and Unger 1996).…”

Section: Introductionmentioning

confidence: 99%

Modeling of patient flows in a large-scale outpatient hospital ward by making use of electronic medical records

Takakuwa

Katagiri

2007

2007 Winter Simulation Conference

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All departments of an outpatient hospital ward of Nagoya University hospital were simulated to examine patient flows and congestion. The method of gathering the required data on times for all outpatients and their routes is described in the performing simulation, especially by making use of the electronic medical records. An outpatient visits one or more clinical departments and/or one or more test/inspection rooms, the reception area, and the payment department. In this procedure, a series of data of terminal units and of test/inspection terminals was used to obtain the required input data for performing simulation as well as the electronic medical records. It was found that the proposed procedure was quite effective to perform a simulation of a large-scale hospital to examine patient flows by applying an actual case.

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Reducing time in an emergency room via a fast-track

Cited by 33 publications

References 2 publications

A Queue-Based Monte Carlo Analysis to Support Decision Making for Implementation of an Emergency Department Fast Track

A Queue-Based Monte Carlo Analysis to Support Decision Making for Implementation of an Emergency Department Fast Track

Modelling patient arrivals when simulating an Accident and Emergency Unit

Modeling of patient flows in a large-scale outpatient hospital ward by making use of electronic medical records

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