TY - JOUR
T1 - Improving the design and operation of an integrated emergency post via simulation
AU - Borgman, N.J.
AU - Mes, M.R.K.
AU - Vliegen, I.M.H.
AU - Hans, E.W.
PY - 2015/5
Y1 - 2015/5
N2 - In the Netherlands, patients with an acute care demand after office hours often wrongly choose to visit the emergency department (ED),while they could have visited the general practitioners’ post (GPP). This may lead to overcrowding and increased costs. In this paper, we focus on an Integrated Emergency Post (IEP) at a Dutch hospital, where the ED and the GPP have been merged into a single point of access for patients. To find the optimal process design for this new IEP, we use computer simulation incorporating patient preferences. We define many potential interventions, and compare these by categorizing and grouping them, and sequen- tially withdrawing ineffective interventions, while accounting for possible interaction effects. Results show a sustainable solution for all stakeholders involved, reducing patients’ length of stay up to 17%. Based on these results, an intervention has been trialled in practice, showing a decrease in patient LOS.
AB - In the Netherlands, patients with an acute care demand after office hours often wrongly choose to visit the emergency department (ED),while they could have visited the general practitioners’ post (GPP). This may lead to overcrowding and increased costs. In this paper, we focus on an Integrated Emergency Post (IEP) at a Dutch hospital, where the ED and the GPP have been merged into a single point of access for patients. To find the optimal process design for this new IEP, we use computer simulation incorporating patient preferences. We define many potential interventions, and compare these by categorizing and grouping them, and sequen- tially withdrawing ineffective interventions, while accounting for possible interaction effects. Results show a sustainable solution for all stakeholders involved, reducing patients’ length of stay up to 17%. Based on these results, an intervention has been trialled in practice, showing a decrease in patient LOS.
KW - design of experiments
KW - emergency department
KW - general practitioners post
KW - logistics
KW - simulation
U2 - 10.1057/jos.2014.5
DO - 10.1057/jos.2014.5
M3 - Article
SN - 1747-7778
VL - 9
SP - 99
EP - 110
JO - Journal of Simulation
JF - Journal of Simulation
IS - 2
ER -