Effect of different patient peak arrivals on an emergency department via discrete event simulation: a case study

SIMULATION ◽  
2021 ◽  
pp. 003754972110387
Author(s):  
Giordano Fava ◽  
Tommaso Giovannelli ◽  
Mauro Messedaglia ◽  
Massimo Roma

Emergency department (ED) overcrowding is a well-recognized worldwide phenomenon which affects the quality of emergency care. A direct consequence of overcrowding is a long wait for visit and treatment of people who require primary care, possibly endangering the lives of critical patients. Healthcare management literature devoted to analyze ED operational policies is very wide, and many approaches have been proposed to address this important problem. However, less attention has been given to patient peak arrivals caused by the occurrence of some critical events which can strongly strain the operational efficiency of an ED. In this paper, we consider the particular case study of a medium-size ED located in a region of Central Italy recently hit by a severe earthquake, aiming at assessing the effects of such an occurrence on the ED operation. In particular, we propose a discrete event simulation (DES) model to analyze the patient flows through this ED, simulating unusual operational conditions due to a critical event, like a natural disaster, which causes a sudden spike in the number of patient arrivals. The availability of detailed data concerning the ED processes enabled building an accurate DES model and performing extensive scenario analyses. The model provides a valid decision support system for the ED managers in assessing specific emergency plans to be activated in case of mass casualty disasters.

2016 ◽  
Vol 19 (7) ◽  
pp. A624 ◽  
Author(s):  
RA Ribeiro ◽  
EN Baungratz ◽  
G Vaccaro ◽  
PS Schmitz ◽  
AK Fernandes ◽  
...  

2015 ◽  
pp. 390-410
Author(s):  
Stavros T. Ponis ◽  
Angelos Delis ◽  
Sotiris P. Gayialis ◽  
Panagiotis Kasimatis ◽  
Joseph Tan

This paper highlights the opportunities and challenges of applying Discrete Event Simulation (DES) to support capacity planning of a network of outpatient facilities. Despite an abundance of studies using simulation techniques to examine the operation and performance of outpatient clinics, the problem of capacity allocation and planning of medical services within a network of outpatient healthcare facilities appears to be underexplored. Here, a case study of a health insurance provider that operates a network of six outpatient medical facilities in the US is used to illustrate and explore the synthesizing and adaptive, yet parsimonious nature of using DES methodology for network design and capacity planning. Results of this case study demonstrate that significant performance improvements for the network operator can be achieved with applying DES method to support the network facility capacity planning process.


Author(s):  
Ana Carolina Pereira de Vasconcelos Silva ◽  
Daniel Bouzon Nagem Assad ◽  
Thais Spiegel

The operations management is a multidisciplinary field that investigates, for instance, the design, management and processes improvement focused on the development, production, distribution and delivery of products and services, encompassing activities such as the implementation of policies, making quota decisions, identification and problem solving, response to uncertainty, among others. Regarding the resources dimensioning in hospitals, the Brazilian scenario is limited to legislative instruments that assume a prior and added sizing. This chapter uses a discrete event simulation tool to set the amount of operation rooms needed for patient care in an emergency department, so that emergency patients have guaranteed compliance, minimizing the cancellation of elective surgeries because of this type of demand. As a result, it was found that the minimum amount established by normative instruments was not appropriate to the specific requirements of the organization.


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