A Simulation Analysis for the Shortening of the Patients' Stay Time in the Emergency Department

응급실 체류시간 단축을 위한 시뮬레이션 분석

  • Lee, Jung-Man (Department of Information and industrial Engineering, Yonsei University) ;
  • Kim, Mi-Yi (Department of Information and industrial Engineering, Yonsei University) ;
  • Kim, Dong-Hyun (Department of Information and industrial Engineering, Yonsei University) ;
  • Lee, Jong-Il (Department of Information and industrial Engineering, Yonsei University) ;
  • Kim, Ki-Man (Department of Information and industrial Engineering, Yonsei University) ;
  • Lee, Young-Hoon (Department of Information and industrial Engineering, Yonsei University) ;
  • Kim, Seung-Ho (Department of Emergency, Severance Hospital) ;
  • Park, Yu-Suk (Department of Emergency, Severance Hospital)
  • 이정만 (연세대학교 정보산업공학과) ;
  • 김미이 (연세대학교 정보산업공학과) ;
  • 김동현 (연세대학교 정보산업공학과) ;
  • 이종일 (연세대학교 정보산업공학과) ;
  • 김기만 (연세대학교 정보산업공학과) ;
  • 이영훈 (연세대학교 정보산업공학과) ;
  • 김승호 (연세의료원 응급의학과) ;
  • 박유석 (연세의료원 응급의학과)
  • Published : 2009.12.31

Abstract

The purpose of this research is to find the reasons of overcrowding in the emergency department of an hospital, then to shorten the total stay time of patients. The fact that main causes of the overcrowding exist in the process of the emergency department was discovered by analysis of the data. In order to improve these process, simulation model was developed by ARENA 7.0. Staff's service time, staff's organization, process ratio, and patient's waiting time were estimated in the simulation model in consideration of the decision of the patient's course of action. Several scenarios such as the simplification of the process, the setup of dedicated pathology lab, and mixed method were suggested and evaluated. Total stay time of the patients would be reduced up to 28.45%.

Keywords

References

  1. Connelly, L. G., and Bair, A. E.; “Discrete Event Simulation of Emergency Department Activity : A Platform for Systemlevel Operations,” ACAD EMERG MED, 11(11) : 1177-1185, 2004 https://doi.org/10.1111/j.1553-2712.2004.tb00702.x
  2. Litvak, E.; “Boston hospital sees big impact from smoothing elective schedule,” OR Manager, 20(12) : 1-5, 2004
  3. Litvak, E., Buerhaus, P. I., Davidoff, F., Long, M. C., McManus, M. L., and Berwick, D. M.; “Managing Unnecessary Variability in Patient Demand to Reduce Nursing Stress and Improve Patient Safety,” Journal on Quality and Patient Safety, 31(6) : 330-338, 2005. https://doi.org/10.1016/S1553-7250(05)31044-0
  4. Macdonald, S. J., Karam, I., Al-Shirrawi, N., Chowdhary, R. K., Escalante, E. M., and Afandi, A.; “Emeregency Department Process Improvement,” In Proceedings of the 2005 System and Information Engineering Design Symposium, 253-262, 2005
  5. Naylor, T. H. and Finger, J. M.; “Verification of Computer Simulation Models,” Management Science, 2 : 92-101, 1967 https://doi.org/10.1287/mnsc.14.2.B92
  6. Rossetti, M. D., Trzcinski, G. F., and Syverud, S. A.; “Emergency Department Simulation and Determination of Optimal Attending Physician Staffing Schedules,” Proceedings of the 1999 Winter Simulation Conference, 1532-1540, 1999 https://doi.org/10.1145/324898.325315
  7. Su, S. and Shih, C. L.; “Resource reallocation in an emergency medical service system using computer simulation,” American Journal of Emergency Medicine, 20(7) : 627-634, 2002 https://doi.org/10.1053/ajem.2002.35453