scholarly journals Discrete event simulation modelling for an improved patient flow at the Emergency Department, Sygehus Lillebælt, Kolding

2012 ◽  
Vol 19 (S2) ◽  
Author(s):  
Dawid Kozlowski ◽  
Christian Backer Mogensen ◽  
Niels Christian Petersen
Keyword(s):  
Emergency Department ◽  
Discrete Event Simulation ◽  
Patient Flow ◽  
Discrete Event ◽  
Simulation Modelling ◽  
Event Simulation

Discrete event simulation modelling to evaluate the impact of a quality improvement initiative on patient flow in a paediatric emergency department

2020 ◽  
Vol 37 (4) ◽  
pp. 193-199 ◽  
Author(s):  
Kenneth W McKinley ◽  
John Babineau ◽  
Cindy G Roskind ◽  
Meridith Sonnett ◽  
Quynh Doan
Keyword(s):  
Quality Improvement ◽  
Discrete Event Simulation ◽  
Patient Flow ◽  
Discrete Event ◽  
Simulation Modelling ◽  
Quality Improvement Initiative ◽  
Event Simulation ◽  
Specific Protocol ◽  
Time Specific ◽  
The Impact

ObjectiveWe developed a discrete event simulation model to evaluate the impact on system flow of a quality improvement (QI) initiative that included a time-specific protocol to decrease the time to antibiotic delivery for children with cancer and central venous catheters who present to a paediatric ED with fever.MethodsThe model was based on prospective observations and retrospective review of ED processes during the maintenance phase of the QI initiative between January 2016 and June 2017 in a large, urban, academic children’s hospital in New York City, USA. We compared waiting time for full evaluation (WT) and length of stay (LOS) between a model with and a model without the protocol. We then gradually increased the proportion of patients receiving the protocol in the model and recorded changes in WT and LOS.ResultsWe validated model outputs against administrative data from 2016, with no statistically significant differences in average WT or LOS for any emergency severity index (ESI). There were no statistically significant differences in these flow metrics between the model with and the model without the protocol. By increasing the proportion of total patients receiving this protocol, from 0.2% to 1.3%, the WT increased by 2.8 min (95% CI: 0.6 to 5.0) and 7.6 min (95% CI: 2.0 to 13.2) for ESI 2 and ESI 3 patients, respectively. This represents a 14.0% increase in WT for ESI 3 patients.ConclusionsSimulation modelling facilitated the testing of system effects for a time-specific protocol implemented in a large, urban, academic paediatric ED, showing no significant impact on patient flow. The model suggests system resilience, demonstrating no detrimental effect on WT until there is a 7-fold increase in the proportion of patients receiving the protocol.

Computer Modeling of Patient Flow in a Pediatric Emergency Department Using Discrete Event Simulation

2007 ◽  
Vol 23 (1) ◽  
pp. 5-10 ◽  
Author(s):  
Geoffrey R. Hung ◽  
Sandra R. Whitehouse ◽  
Craig O'Neill ◽  
Andrew P. Gray ◽  
Niranjan Kissoon
Keyword(s):  
Emergency Department ◽  
Computer Modeling ◽  
Discrete Event Simulation ◽  
Patient Flow ◽  
Discrete Event ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Event Simulation

scholarly journals Factors Influencing Door-To-Doctor Time In An Emergency Department: Discrete Event Simulation Model

2016 ◽  
Vol 19 (7) ◽  
pp. A624 ◽  
Author(s):  
RA Ribeiro ◽  
EN Baungratz ◽  
G Vaccaro ◽  
PS Schmitz ◽  
AK Fernandes ◽  
...  
Keyword(s):  
Emergency Department ◽  
Simulation Model ◽  
Discrete Event Simulation ◽  
Discrete Event ◽  
Event Simulation ◽  
Discrete Event Simulation Model ◽  
Factors Influencing

Capacity Decision in Emergency Hospital Operation Rooms

2018 ◽  
pp. 140-155
Author(s):  
Ana Carolina Pereira de Vasconcelos Silva ◽  
Daniel Bouzon Nagem Assad ◽  
Thais Spiegel
Keyword(s):  
Emergency Department ◽  
Problem Solving ◽  
Discrete Event Simulation ◽  
Operations Management ◽  
Discrete Event ◽  
Design Management ◽  
Simulation Tool ◽  
Event Simulation ◽  
Production Distribution ◽  
Capacity Decision

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.

scholarly journals The application of a hybrid simulation modelling framework as a decision-making tool for TPM improvement

2019 ◽  
Vol 25 (3) ◽  
pp. 476-498 ◽  
Author(s):  
Omogbai Oleghe ◽  
Konstantinos Salonitis
Keyword(s):  
Discrete Event Simulation ◽  
Hybrid Model ◽  
Discrete Event ◽  
Simulation Modelling ◽  
Hybrid Modelling ◽  
Content Type ◽  
Event Simulation ◽  
Modelling Framework ◽  
Field Notes

Purpose The purpose of this paper is to promote a system dynamics-discrete event simulation (SD-DES) hybrid modelling framework, one that is useful for investigating problems comprising multifaceted elements which interact and evolve over time, such as is found in TPM. Design/methodology/approach The hybrid modelling framework commences with system observation using field notes which culminate in model conceptualization to structure the problem. Thereafter, an SD-DEShybrid model is designed for the system, and simulated to proffer improvement programmes. The hybrid model emphasises the interactions between key constructs relating to the system, feedback structures and process flow concepts that are the hallmarks of many problems in production. The modelling framework is applied to the TPM operations of a bottling plant where sub-optimal TPM performance was affecting throughput performance. Findings Simulation results for the case study show that intangible human factors such as worker motivation do not significantly affect TPM performance. What is most critical is ensuring full compliance to routine and scheduled maintenance tasks and coordinating the latter to align with rate of machine defect creation. Research limitations/implications The framework was developed with completeness, generality and reuse in view. It remains to be applied to a wide variety of TPM and non-TPM-related problems. Practical implications The developed hybrid model is scalable and can fit into an existing discrete event simulation model of a production system. The case study findings indicate where TPM managers should focus their efforts. Originality/value The investigation of TPM using SD-DES hybrid modelling is a novelty.

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