scholarly journals Applications of RFID Systems in Healthcare Management: A Simulation for Emergency Department

2019 ◽  
Vol 8 (10) ◽  
pp. 786-792
Keyword(s):  
Patient Satisfaction ◽  
Emergency Departments ◽  
Medical Staff ◽  
Improve Patient Safety ◽  
Patient Flow ◽  
Tracking System ◽  
Waiting Times ◽  
Complex Structure ◽  
Healthcare Management ◽  
Heart Attacks

Emergency Departments are the most complex and busiest locations for patient flow in hospitals. Treatment of acute diseases, accidental injuries, heart attacks or different medical applications are performed in these centers. At this point, patients should receive effective treatments as soon as possible. Additionally, they can include in medical procedures such as triage, registration, treatment, transfer or hospitalization when they apply of this departments. There are many problems in these services due to their complex structure. For instance; long waiting times, leaving the hospital without excuse or without payment, lack of bed or medical staff, long staying times. For these reasons, patient cares and treatments will be affected. It is thought that using of RFID Technology will be expanded in the Emergency Departments that it may decrease long waiting times, improve the quality of treatment processes and increase patient satisfaction also. In this study, it is aimed to improve patient safety and quality with sustainable tracking system. In addition, a real-time warning mechanism will be created by determining the number of optimum medical staff due to this technology. As a result, length of stay of the patients will be reduced and patient satisfaction will be increased in Emergency Departments.

scholarly journals Waiting times in emergency departments: exploring the factors associated with longer patient waits for emergency care in England using routinely collected daily data

2020 ◽  
pp. emermed-2019-208849
Author(s):  
Steven Paling ◽  
Jennifer Lambert ◽  
Jasper Clouting ◽  
Júlia González-Esquerré ◽  
Toby Auterson
Keyword(s):  
Emergency Departments ◽  
Fixed Effects ◽  
Patient Flow ◽  
Waiting Times ◽  
Healthcare Providers ◽  
Ordinary Least Squares ◽  
Hospital Length Of Stay ◽  
Bed Occupancy ◽  
Point Change ◽  
Factors Associated

BackgroundLong lengths of stay (also called waiting times) in emergency departments (EDs) are associated with higher patient mortality and worse outcomes.ObjectiveTo add to the literature using high-frequency data from a large number of hospitals to analyse factors associated with long waiting times, including exploring non-linearities for 'tipping points'.MethodsMultivariate ordinary least squares regressions with fixed effects were used to analyse factors associated with the proportion of patients in EDs in England waiting more than 4 hours to be seen, treated and admitted or discharged. Daily situation reports (Sitrep), hospital episode statistics and electronic staffing records data over 90 days between December 2016 and February 2017 were used for all 138 English NHS healthcare providers with a major ED.ResultsHigher inpatient bed occupancy was correlated with longer ED waiting times, with a non-linear association. In a full hospital, with 100% bed occupancy, the proportion of patients who remained in the ED for more than 4 hours was 9 percentage points higher (95% CI 7.5% to 11.1%) than with an 85% occupancy level. For each percentage point change in the following factors, the proportion of ED stays over 4 hours also increased: more inpatients with hospital length of stay over 21 days (0.07%, 95% CI 0.008% to 0.13%); higher emergency admissions (0.08%, 95% CI 0.06% to 0.10%); and lower discharges relative to admissions on the same day (0.04%, 95% CI 0.02% to 0.06%), the following day (0.05%, 95% CI 0.03% to 0.06%) and at 2 days (0.05%, 95% CI 0.04% to 0.07%).ConclusionsThese results suggest that tackling patient flow and capacity in the wider hospital, particularly very high bed occupancy levels and patient discharge, is important to reduce ED waiting times and improve patient outcomes.

Patient satisfaction in hospital-based emergency departments: recommendation for healthcare management and policy

2010 ◽  
Vol 5 (2/3) ◽  
pp. 175 ◽  
Author(s):  
Blossom Yen Ju Lin ◽  
Chung Ping Cliff Hsu ◽  
Cheng Hua Lee ◽  
Ming Chin Chao
Keyword(s):  
Patient Satisfaction ◽  
Emergency Departments ◽  
Healthcare Management

scholarly journals Modeling, Assessment and Design of an Emergency Department of a Public Hospital through Discrete-Event Simulation

2021 ◽  
Vol 11 (2) ◽  
pp. 805
Author(s):  
Alexandre Castanheira-Pinto ◽  
Bruno S. Gonçalves ◽  
Rui M. Lima ◽  
José Dinis-Carvalho
Keyword(s):  
Emergency Department ◽  
Simulation Model ◽  
Emergency Departments ◽  
Patient Flow ◽  
Waiting Times ◽  
Discrete Event ◽  
Analytical Description ◽  
Northern Region ◽  
Optimized Design ◽  
Initial State

Emergency departments in hospitals are having many difficulties in achieving the performance levels required by health regulators and society. The waiting times as well as the total throughput time are examples of performance indicators that emergency departments need to improve in order to provide a better service to the community. To achieve improvement of performance, the present paper shows a methodology to assist the design process of an emergency department using simulation techniques. In this study, the emergency department of a hospital located in the northern region of Portugal was considered to test the proposed simulation technique. The emergency department initial state was assessed, in terms of patient flow, as well as the human resources needed at every stage of the service. In order to understand in depth the process that a patient goes through during an emergency episode, a comprehensive study was performed on the hospital database. This allowed the analytical description of an emergency episode, which was further used as an input to the simulation model. After developing the simulation model with the information obtained by the hospital’s database, a validation stage was performed. Finally, in order to achieve an optimized design for the emergency department several variant scenarios were considered and evaluated. This methodology proved to be very useful in determining an optimized operation for complex, and non-linear systems.

scholarly journals 6 Improving Patient Flow in a Multi-Specialty Assessment Area by Introducing Referral Pathways for Orthopaedics and Plastic Surgery during the COVID-19 Pandemic

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
G Gordon ◽  
A Fadulelmola ◽  
S Scott
Keyword(s):  
Plastic Surgery ◽  
Emergency Departments ◽  
Patient Flow ◽  
Waiting Times ◽  
Hospital Setting ◽  
District General Hospital ◽  
Improvement Project ◽  
Specialty Area ◽  
Referral Criteria ◽  
Orthopaedic Patients

Abstract Introduction The COVID-19 pandemic has seen fundamental organisational changes to emergency departments internationally. Specialties throughout the hospital setting have been asked to change their working practice, often with the aim of adapting to new processes in emergency departments. Early in the pandemic, the orthopaedic team at one district general hospital were required to provide 24/7 onsite cover in a multi-specialty area. Confusion over the referral pathways of two specialties (orthopaedics and plastic surgery) led to increase waiting times, constrained patient flow and poor patient and staff satisfaction. Method This quality improvement project occurred over three cycles of data collection and intervention over a two-month period. A novel referral pathway was developed and implemented after discussion with consultants in orthopaedics, plastics, and emergency medicine. Interventions included staff teaching, clarifying of roles at morning meetings and the deployment of posters. Results In cycle 1, 39% of orthopaedic referrals were inappropriately referred. By cycle 3, 0% of orthopaedic patients were inappropriately referred. Average time in department for patients referred to orthopaedics improved from 124 minutes to 88 minutes. Staff reported increased satisfaction, with appreciation for the clarification on referral criteria. Conclusions This QUIP demonstrates how simple interventions during times of crisis can solve complex organisational issues.

scholarly journals Performance analysis in emergency departments: a data-driven approach

2018 ◽  
Vol 22 (2) ◽  
pp. 130-145 ◽  
Author(s):  
Alessandro Stefanini ◽  
Davide Aloini ◽  
Elisabetta Benevento ◽  
Riccardo Dulmin ◽  
Valeria Mininno
Keyword(s):  
Real Time ◽  
Emergency Departments ◽  
Process Mining ◽  
Patient Flow ◽  
Waiting Times ◽  
Simulation Models ◽  
Data Driven ◽  
Content Type ◽  
Actual Patient ◽  
Data Driven Approach

PurposeThis paper aims to investigate the process performances in Emergency Departments (EDs) with a novel data-driven approach, permitting to discover the entire patient-flow, deploy the performances in term of time and resources on the activities and flows and identify process deviations and critical bottlenecks. Moreover, the use of this methodology in real time might dynamically provide a picture of the current situation inside the ED in term of waiting times, crowding, resources, etc., supporting the management of patient demand and resources in real time.Design/methodology/approachThe proposed methodology exploits the process-mining techniques. Starting from the event data inside the hospital information systems, it permits automatically to extract the patient-flows, to evaluate the process performances, to detect process exceptions and to identify the deviations between the expected and the actual results.FindingsThe application of the proposed method to a real ED revealed being valuable to discover the actual patient-flow, measure the performances of each activity with respect to the predefined targets and compare different operating situations.Practical implicationsStarting from the results provided by this system, hospital managers may explore the root causes of deviations, identify areas for improvements and hypothesize improvement actions. Finally, process-mining outputs may provide useful information for creating simulation models to test and compare alternative ED operational scenarios.Originality/valueThis study responds to the need of novel approaches for monitoring and evaluating processes performances in the EDs. The novelty of this data-driven approach is the opportunity to timely connect performances, patient-flows and activities.

Principles of capacity management, applied in the mental health context

2018 ◽  
Vol 42 (4) ◽  
pp. 438
Author(s):  
Kathryn Zeitz ◽  
Darryl Watson
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Average Length ◽  
Patient Flow ◽  
Waiting Times ◽  
Capacity Management ◽  
Mental Health Setting ◽  
Mental Health Consumer ◽  
Mental Health Consumers ◽  
Flow Improvement

Objective The aim of the paper was to describe a suite of capacity management principles that have been applied in the mental health setting that resulted in a significant reduction in time spent in two emergency departments (ED) and improved throughput. Methods The project consisted of a multifocal change approach over three phases that included: (1) the implementation of a suite of fundamental capacity management activities led by the service and clinical director; (2) a targeted Winter Demand Plan supported by McKinsey and Co.; and (3) a sustainability of change phase. Descriptive statistics was used to analyse the performance data that was collected through-out the project. Results This capacity management project has resulted in sustained patient flow improvement. There was a reduction in the average length of stay (LOS) in the ED for consumers with mental health presentations to the ED. At the commencement of the project, in July 2014, the average LOS was 20.5 h compared with 8.5 h in December 2015 post the sustainability phase. In July 2014, the percentage of consumers staying longer than 24 h was 26% (n = 112); in November and December 2015, this had reduced to 6% and 7 5% respectively (less than one consumer per day). Conclusion Improving patient flow is multifactorial. Increased attendances in public EDs by people with mental health problems and the lengthening boarding in the ED affect the overall ED throughput. Key strategies to improve mental health consumer flow need to focus on engagement, leadership, embedding fundamentals, managing and target setting. What is known about the topic? Improving patient flow in the acute sector is an emerging topic in the health literature in response to increasing pressures of access block in EDs. What does this paper add? This paper describes the application of a suite of patient flow improvement principles that were applied in the mental health setting that significantly reduced the waiting time for consumers in two EDs. What are the implications for practitioners? No single improvement will reduce access block in the ED for mental health consumers. Reductions in waiting times require a concerted, multifocal approach across all components of the acute mental health journey.

scholarly journals Accelerating High-Throughput Screening for Structural Materials with Production Management Methods

Materials ◽  
2018 ◽  
Vol 11 (8) ◽  
pp. 1330 ◽  
Author(s):  
Alexander Bader ◽  
Finn Meiners ◽  
Kirsten Tracht
Keyword(s):  
High Throughput ◽  
Material Flow ◽  
High Throughput Screening ◽  
Production Management ◽  
Waiting Times ◽  
Complex Structure ◽  
New Drugs ◽  
Order Processing ◽  
Speed Up ◽  
Process Trial

High-throughput screenings are widely accepted for pharmaceutical developments for new substances and the development of new drugs with required characteristics by evolutionary studies. Current research projects transfer this principle of high-throughput testing to the development of metallic materials. In addition to new generating and testing methods, these types of high-throughput systems need a logistical control and handling method to reduce throughput time to get test results faster. Instead of the direct material flow found in classical high-throughput screenings, these systems have a very complex structure of material flow. The result is a highly dynamic system that includes short-term changes such as rerun stations, partial tests, and temporarily paced sequences between working systems. This paper presents a framework that divides the actions for system acceleration into three main sections. First, methods for special applications in high-throughput systems are designed or adapted to speed up the generation, treatment, and testing processes. Second, methods are needed to process trial plans and to control test orders, which can efficiently reduce waiting times. The third part of the framework describes procedures for handling samples. This reduces non-productive times and reduces order processing in individual lots.

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