A Framework For Emergency Department Capacity Planning Using System Dynamics Approach And The Theory Of Constraints Philosophies

Author(s):  
Norazura Ahmad ◽  
Noraida Abdul Ghan ◽  
Anton Abdulbasah Kamil ◽  
Razman Mat Tahar
Author(s):  
Sharon L. Campbell ◽  
Tomas A. Remenyi ◽  
Grant J. Williamson ◽  
Christopher J. White ◽  
Fay H. Johnston

Heatwaves have been identified as a threat to human health, with this impact projected to rise in a warming climate. Gaps in local knowledge can potentially undermine appropriate policy and preparedness actions. Using a case-crossover methodology, we examined the impact of heatwave events on hospital emergency department (ED) presentations in the two most populous regions of Tasmania, Australia, from 2008–2016. Using conditional logistic regression, we analyzed the relationship between ED presentations and severe/extreme heatwaves for the whole population, specific demographics including age, gender and socio-economic advantage, and diagnostic conditions that are known to be impacted in high temperatures. ED presentations increased by 5% (OR 1.05, 95% CI 1.01–1.09) across the whole population, by 13% (OR 1.13, 95% CI 1.03–1.24) for children 15 years and under, and by 19% (OR 1.19, 95% CI 1.04–1.36) for children 5 years and under. A less precise association in the same direction was found for those over 65 years. For diagnostic subgroups, non-significant increases in ED presentations were observed for asthma, diabetes, hypertension, and atrial fibrillation. These findings may assist ED surge capacity planning and public health preparedness and response activities for heatwave events in Tasmania, highlighting the importance of using local research to inform local practice.


Author(s):  
Boaz Ronen ◽  
Joseph S Pliskin ◽  
Shimeon Pass

This chapter describes some success stories that show how the tools, methods, and philosophies were used in a variety of healthcare systems. The cases presented here include successful implementations in the United States, United Kingdom, and Israel. Each story highlights the objectives and the results of the organization. Objectives include reducing emergency room wait times, reducing delayed admissions, improving emergency department and operating room throughput, improving quality and customer satisfaction. Although the cases use a variety of methods, approaches include eliminating dummy constraints, using specific contribution for prioritization, and working with complete kits, focusing on the theory of constraints, and reducing work in progress.


Author(s):  
Boaz Ronen ◽  
Joseph S. Pliskin ◽  
Shimeon Pass ◽  
Donald M. Berwick

The Hospital and Clinic Improvement Handbook is about doing more using existing resources. For example, achieving more throughput in the operating rooms, reducing waiting times at the emergency department, and improving clinical quality. This is done using the well-established Lean techniques together with the breakthrough philosophies and techniques of the theory of constraints (TOC). These methods and their underlying tools are put together with techniques and methodologies implemented by the authors in dozens of healthcare organizations. The tools include the complete kit concept, the Pareto methodology, the focusing table, and the focusing matrix. The book introduces simple tools that can be implemented quite easily in any hospital or clinic. It also focuses on the implementation process using tools like the 3–1–1 model that directs managers where to focus their limited time resources to best improve the performance of their organizations. Finally, the book introduces effective yet simple performance measures and prescribes the process of ongoing improvement.


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