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2.pdf - International Journal of Advanced Technology...

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International Journal of Advanced Technology & Engineering Research (IJATER) www.ijater.com ISSN No: 2250-3536 Volume 3, Issue 2, March 2013 79 EXPLOITING SIMULATION TO REDUCE PATIENT WAITING TIME USING A STREAMING STRATEGY IN AN EMERGENCY DEPARTMENT Entisar Aboukanda, Muhammad Latif School of Engineering, Manchester metropolitan University [email protected] & [email protected] Abstract In this study, simulation is used to develop a model that represents the Emergency Department (ED) at Tripoli Medi- cal Centre (TMC), in Libya. By using simulation modelling, patient flow in the ED can be imitated to determine the most critical process for improvement in quality of care (meas- ured by patient waiting time (WT) and length of stay (LOS)). A streaming strategy was implemented into the examina- tion area of the ED, which enabled patients/staff into smaller teams in order to increase efficiency without the need to increase costs. The streaming strategy looks into how a more effective patient route can be developed, allowing pa- tients to go through the system faster according to their spe- cific emergencies and treatments. The changes applied resulted in many improvements, most importantly, the examination area now processed patients faster resulting in a decrease in WT and a shorter LOS. The cardiology area within the ED had a decrease in the number patients waiting and the overall cardiologic patient time had decreased. Pressure has also been released from the observa- tion area as they process a decrease number of patients al- lowing more important cases to be handled accordingly. Keywords: simulation, Emergency Departments, Waiting time, Overcrowding, streaming, 1 Introduction An Emergency Department (ED) is a medical treatment facility, which specialises in the acute care of patients who attend without a prior appointment arriving either by their own means or via ambulance [1]. Because of the lack of predictability with regard to patient numbers and require- ments, it is imperative that the department is able to deliver a range of treatments suitable for a vast array of injuries and illnesses. Critically, some of these conditions may be con- sidered life threatening, and may therefore necessitate im- mediate, urgent action . Nevertheless, EDs are experiencing many different obstacles and issues owing to the fact that there has been a significant surge in patient demand; this has subsequently induced the need to ensure services and overall patient care quality is improved. Within hospital ED, one of the most significant and urgent operational issue is patient overcrowding, which is recognised as a threat to public health and patient safety [2,3,4]. Considerable attention has been devoted to the study of the root causes of overcrowding and the effects on health- care services in critical hospital departments in Europe and the USA. The results indicated that there are multiple factors which contribute to creating a situation of overcrowding in emergency departments, such as [5, 6,7]: An increase in patient volume
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