A Simulation Study or Patient Flow Improvment Modes

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Analytics and Systems Engineering

David Ben-Arieh
Professor of Industrial Engineering
Kansas State University

John Wu
Kansas State University

This presentation shows how a simulation study in a large emergency department used to validate the data measured in the facility and more importantly infer new critical information. In addition, the simulation compared seven alternative methods to improve patient flow in the facility showing the relative merit of each approach.

This presentation shows a simulation study in a large academic medical center's emergency department. The simulation validated the data collected at the facility and generated new information such as the time that patients are willing to wait before leaving without being seen. The detailed simulation is modular and can be implemented at any emergency department. In addition, the simulation studies seven proposed approached to improve patient flow, reduce waiting time, and reduce premature departures (leave without being seen, leave before treatment complete and leave against medical advice). The seven approaches expand on the fast track concept, better integrate the in-patient room assignment process, modify the ESI level assignment, or allows dynamic room allocation in various forms. The presentation discusses each proposed improvement approach, and then shows the impact of each approach on the ED performance as well as the financial impact on the emergency department. All together, we will show how the simulation model was used to infer new information not completely understood before, suggest seven approaches to process improvement and show the relative merit of each such approach. In addition we will present improvement approaches and results from similar facilities in Europe.