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Hospital Emergency Department Simulation for Resource Analysis

  • Kozan, Erhan;Diefenbach, Mel
    • Industrial Engineering and Management Systems
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    • v.7 no.2
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    • pp.133-142
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    • 2008
  • The Emergency Department (ED) is an integral part of hospitals. Admissions from the ED account for a significant proportion for a hospital's activity. Ensuring a timely and efficient flow of patients through the ED is crucial for optimising patient care. In recent years, ED overcrowding and its impact on patient flow has become a major issue facing the health sector. Simulation is rapidly becoming a tool of choice when examining hospital systems due to its capacity to involve numerous factors and interactions that impact the system. An analytical simulation model is used to investigate potential impacts by changing the following aspects of ED (physical layouts; number of beds; number and rate of patient arrivals; acuity of illness or injury of patients; access to radiology and pathology services; hospital staffing arrangements; and access to inpatient beds). Results of a significant numerical investigation at a hospital are also presented.

Evaluation of Cancer Patients Admitted to the Emergency Department within One Month before Death in Turkey: What are the Problems Needing Attention?

  • Yildirim, Birdal;Tanriverdi, Ozgur
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.349-353
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    • 2014
  • Background: Although previously studies have reported that most patients with malignancy prefer to die at home, this is not the real situation in clinical practice. Aim: In this study, we aimed to determine the characteristics of Turkish cancer patients admitted to the emergency department (ED) within one month before death. Materials and Method: This descriptive retrospective study focused on questions about how often and why patients with cancer visited the ED before death. A total of 107 individuals with cancer were divided into 2 groups: Group 1, patients with at least one visit in the final 4 weeks; and Group 2, patients with no visit to ED. Demographic and clinical features were compared between the two groups. Statistical analyses: Descriptive statistical methods, statistical analysis for correlation, Student's t-test, chi-square tests and logistic regression were used. Results: At least one visit to ED within one month before death was reported for 64 (60%) of the 107 cases. Of these 64 (Group 1), 38% (n=24) were discharged and 9% (n=6) died in the ED. The most common site of the primary tumor was the lung (n=24, 38%) and the most common symptom was dyspnea (92%). With the other 43 (40%) cancer patients not presenting to the ED within one month before death, they were more likely to be female with another type of cancer. Conclusions: Guidelines are needed for better management of cancer patients benefiting from visits to ED within the last month of life.

영양소의 증가가 산란 생산성 및 계란 품질에 미치는 영향

  • 김상호;장병귀;최철환;서옥석;이상진;류경선
    • Proceedings of the Korea Society of Poultry Science Conference
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    • 2003.11a
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    • pp.103-104
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    • 2003
  • This experiment was conducted to investigate the effect of enhancement of protein, limit amino acid, Ca and P on egg Production and egg qualify in laying hens. 720 twenty five week of age (WOA) brown laying hen divided to two diet to seventy WOA. Conventional diet(control) formulated by NRC recommendation, 2,900 ME kcal/kg, 16.0 % crude protein, 0.768 % lysine, 0.332 % methionine, 3.5 % Ca and 0.275 available P. Enhanced diet(ED) formulated by increasing about ten percentage except ME and available P : 2,900 ME kcal/kg, 17.7 % crude protein, 0.845 % lysine, 0.368 % methionine, 3.99 % Ca and 0.275 available P. Overall egg Production were not difference by diets though the hens fed control diet tended to higher egg Production to sixty WOA. Average egg weight was heavier in the ED than control in all period(P<0.05). Daily egg mass increased slightly in the ED, but there were not significantly difference. Average feed intake increased about 3g in the control compared to the ED. Feed conversion ratio significantly improved in the ED(P<0.05). Egg shell breaking strength was stronger in ED by around sixty WOA and showed similar tendency after that. Egg shell thickness was certainly improved in ED. Haugh unit. egg shell color and egg yolk color were not difference by diets.

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Impact of an emergency department resident strike during the coronavirus disease 2019 (COVID-19) pandemic in Daegu, South Korea: a retrospective cross-sectional study

  • Cho, Yo Han;Cho, Jae Wan;Ryoo, Hyun Wook;Moon, Sungbae;Kim, Jung Ho;Lee, Sang-Hun;Jang, Tae Chang;Lee, Dong Eun
    • Journal of Yeungnam Medical Science
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    • v.39 no.1
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    • pp.31-38
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    • 2022
  • Background: To prepare for future work stoppages in the medical industry, this study aimed to identify the effects of healthcare worker strikes on the mortality rate of patients visiting the emergency department (ED) at six training hospitals in Daegu, South Korea. Methods: We used a retrospective, cross-sectional, multicenter design to analyze the medical records of patients who visited six training hospitals in Daegu (August 21-September 8, 2020). For comparison, control period 1 was set as the same period in the previous year (August 21-September 8, 2019) and control period 2 was set as July 1-19, 2020. Patient characteristics including age, sex, and time of ED visit were investigated along with mode of arrival, length of ED stay, and in-hospital mortality. The experimental and control groups were compared using t-tests, and Mann-Whitney U-test, chi-square test, and Fisher exact tests, as appropriate. Univariate logistic regression was performed to identify significant factors, followed by multivariate logistic regression analysis. Results: During the study period, 31,357 patients visited the ED, of which 7,749 belonged to the experimental group. Control periods 1 and 2 included 13,100 and 10,243 patients, respectively. No significant in-hospital mortality differences were found between strike periods; however, the results showed statistically significant differences in the length of ED stay. Conclusion: The ED resident strike did not influence the mortality rate of patients who visited the EDs of six training hospitals in Daegu. Furthermore, the number of patients admitted and the length of ED stay decreased during the strike period.

Effect of Daily and Alternate Day Feeding Regimens on Growth and Food Utilization by Juvenile Flounder Paralichtys olivaceus (일일 및 격일 습사료 공급방법이 육성 넙치의 성장과 영양소 이용효율에 미치는 영향)

  • 김정대;신승훈;조구긴;이상민
    • Journal of Aquaculture
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    • v.15 no.1
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    • pp.15-21
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    • 2002
  • Two groups of juvenile flounders (90 g/each) were fed on moist pellet feed thrice a day for a period of 8 weeks; the first group, reared in 4 circular (6m $\times$ 0.8 m) tanks (1200 flounders/tank), was fed daily (ED) and the second one on alternate days (EO). There was no significant difference in growth and feed conversion ratio (FCR) between these groups. There was also no difference in chemical composition, except in lipid, which was significantly higher (4.1%) in the ED group than the EO group (3.4%). Food intake and gain in the whole body nitrogen (N) were higher in the ED group but there was no significant difference between these groups in N retention; they excreted almost equal amount (114 vs 112 g) of N. Although phosphorus intake was significantly different between these groups, the flounders retained equal amount (0.5 g) of P in their body and excreted also equal amount (27.6 vs 26.0 g/kg weight gain) of p. Energy intake (2528 kJ) of the ED group was higher than that (2116 kJ) of the EO group. However, there was no significant difference in their energy retention efficiency. Clearly, alternate day feeding regimen led to more efficient utilization of food by the juvenile flounder.

Ecohydrological Effects of Climate and Land-Use Changes in Jeju Island using Ecosystem Demography Model (ED 모형을 활용한 제주도의 기후 변화 및 토지 이용 변화의 생태수문학적 영향)

  • Kim, Jeongbin;Kim, Yeonjoo
    • Proceedings of the Korea Water Resources Association Conference
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    • 2018.05a
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    • pp.107-107
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    • 2018
  • 기후 변화가 심해짐에 따라 한반도의 기후 또한 온대에서 아열대로 변화하고 있다. 기후대가 변하게 되면 수문학적 순환 및 식생의 분포 또한 달라지게 된다. 식생의 분포는 결국 토지 이용을 의미하며, 서로 다른 토지 이용은 대기와의 상호작용을 통해 각기 다른 반응을 보이게 된다. 본 연구에서는 기후대가 가장 빠르게 변화하고 있는 제주도를 대상으로 기후 변화 및 토지 이용 변화에 따른 생태수문학적 영향을 Ecosystem Demography Model version 2.2(ED-2.2) 모형을 사용하여 살펴 본다. 제주도의 플럭스 타워 및 산림 조사 자료를 활용하여 ED-2.2 모형을 검증하였다. CRU-NCEP 기상자료 및 Land-Use Harmonization (LUH) 토지이용자료를 활용하여 과거기간(1500~2015)의 잠재 식생 및 실제 식생 상태를 산정하고 그 차이를 분석하였다. 산정된 최종 실제 식생 상태를 바탕으로 기후 및 토지이용 시나리오(RCP 3.0 및 6.0)를 적용하고, 다양한 전지구모형(GFDL-ESM2M, HadGEM2-ES, IPSL-CM5A-LR, MIROC5)의 기상자료에 따라 물 순환, 탄소 순환 및 식생의 분포가 어떻게 달라지는 지 분석한다.

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Expression Profiling of Connexins in the Efferent Ductules of Male Rats During Postnatal Development (생후 발달과정동안 숫 백서의 Efferent Ductules에서 Connexins 발현 양상 연구)

  • Lee, K.H.;Choi, I.H.;Chung, C.S.;Chang, J.S.;Kim, J.Y.
    • Journal of Animal Science and Technology
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    • v.49 no.1
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    • pp.15-24
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    • 2007
  • The purpose of this study was to evaluate the presence and differential expression of connexin isoforms in the efferent ductules (ED) of male rat reproductive tract during postnatal development. Total RNA was isolated from the ED collected from rats at 1 week, 2 weeks, 1 month, 3 months, and 6 months of ages. Expression of six connexin mRNAs of 14 isoforms tested was detected by semi-quantitative RT-PCR. Fluctuation of mRNA levels of connexins 26 and 30 was found according to ages. A significant decrease of connexin 31.1 mRNA level was observed in the ED at 1 month of age. The highest levels of connexin 37 and 45 mRNAs were detected in the ED of early developmental period, while the expression of connexin 43 was the lowest at 1 week of age. The present study demonstrates differential regulation on expression of connexin isoforms in the rat ED in age-dependent manner.

Growth Promotion of Tomato by Application of Immobilized Arthrobacter woluwensis ED in Alginate Beads (Alginate에 고정화된 Arthrobacter woluwensis ED 처리 시 토마토의 생장촉진과 균주의 토양 내 잔류)

  • Kwon, Seung-Tak;Song, Hong-Gyu
    • Korean Journal of Microbiology
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    • v.50 no.1
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    • pp.40-45
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    • 2014
  • In order to increase the persistence of plant growth promoting rhizobacteria (PGPR) in rhizpsphere soil, the growth of tomato was examined after the application of Arthrobacter woluwensis ED immobilized in alginate bead, which was known as PGPR. When tomato seedlings were treated with A. woluwensis ED of $1{\times}10^6$ cells g $soil^{-1}$ and incubated for 30 days in a plant growth chamber, the shoot length, root length, fresh weight and dry weight of the grown tomato plants treated with the suspended inoculants significantly increased by 36.2, 59, 51.1, and 37.5%, respectively compared to those of the uninoculated control. The treatment of the immobilized bacteria increased those by 42, 67.4, 62.5, and 60.4%, respectively compared to those of the uninoculated control. Therefore, the enhancement of tomato growth by the treatment of the immobilized bacteria was higher than those by the suspended inoculants. The effects of the inoculation on indigenous bacterial community and the fate of the inoculated bacteria were monitored by denaturing gradient gel electrophoresis analysis. The DNA band intensity of A. woluwensis ED in the tomato rhizosphere treated with the suspended inoculants continuously decreased after the inoculation, but the band intensity in the tomato rhizosphere soils treated with the immobilized inoculants showed the maximum at 1 week after inoculation and the decreasing rate was less than that of the suspended inoculants, which indicated the longer maintenance of the immobilized bacteria at rhizosphere soils. Therefore, encapsulation of PGPR in alginate beads may be more effective than liquid inoculant for the plant growth promotion and survival of PGPR at plant rhizosphere.

Characteristics of Korean Poisoning Patients: Retrospective Analysis by National Emergency Department Information System (한국 중독환자의 경향: 국가응급진료 정보망을 이용한 후향적 연구)

  • Kim, Woongki;Kim, Kyung Hwan;Shin, Dong Wun;Park, Junseok;Kim, Hoon;Jeon, Woochan;Park, Joon Min;Kim, Jung Eon;Kim, Hyunjong
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.2
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    • pp.108-117
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    • 2019
  • Purpose: The study examined the poisoned patients' characteristics nationwide in Korea by using data from the National Emergency Department Information System (NEDIS). Methods: Among the patients' information sent to NEDIS from January 1, 2013 to December 31, 2015, the included subjects' main diagnosis in ED showed poisoning according to the 7th edition of the Korean Standard Disease Classification (KCD-7). We analyzed the patients' gender, age, initial vital signs, visit time, stay time of staying in ED, results of ED care, main diagnosis in ED, length of hospitalization, and results of hospitalization. Results: A total of 106,779 ED visits were included in the analysis. There were 55,878 males (52.3%), which was more than the number of females. The number of intentional poisoning was 49,805 (59.6%). 75,499 cases (70.8%) were discharged, and 25,858 cases (24.2%) were hospitalized. The numbers of poisoning patients per 1,000 ED visits were 14 in Chungnam and 11.9 in Jeonbuk. The most common cause of poisoning, according to the main diagnosis, was venomous animals. It was the same for hospitalized patients, and pesticide was next. Pesticide was the most common cause of mortality in ED (228 cases, 46.1%) and after hospitalization (584 cases, 54.9%). The incidence of poisoning by age group was frequent for patients in their 30s to 50s, and mortality in ED and post-hospitalization were frequent for patients in their 60s to 80s. Conclusion: This study investigated the characteristics of poisoning patients reported in the past 3 years. Pesticide poisoning had a high mortality rate for patients in ED and in-hospital. For mortality, there was a high proportion of elderly people over 60. Thus, policy and medical measures are needed to reduce this problem. Since it is difficult to identify the poison substance in detail due to nature of this study, it is necessary to build a database and monitoring system for monitoring the causative substance and enacting countermeasures.