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Simulation-Based Design of ED Operations with Care Streams to Optimize Care Delivery and Reduce Length of Stay in the Emergency Department

  • Systems-Level Quality Improvement
  • Published:
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Abstract

Faced with the opportunity to significantly deviate from classic operations, a new emergency department (ED) and novel strategy for patient care delivery were simultaneously initiated with the aid of model-based simulation. To answer the design and implementation questions, a traditional strategy for construction of discrete-eventmodel simulation was employed to define ED operations for a newly constructed facility in terms of workflow, variables, resources, structure, process logic and associated assumptions. Benefits were achieved before, during and after implementation of an unprecedented operations strategy—i.e., the organization of the ED care delivery around four care streams: Critical, Diagnostic, Therapeutic and Fast Track. Prior to opening, it shed light on the range of context variables where benefits might be anticipated, and it facilitated staff understanding and judgements of performance. Two years after opening, the operations data is compared to the simulation with encouraging results that shed light on where to continue pursuit of improvement.

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Authors and Affiliations

  1. Biomedical Informatics, College of Medicine, Texas A&M Health Science Center, Bryan, TX, 77807, USA

    Duane Steward

  2. Department of Management, Clemson University, Clemson, SC, 29634, USA

    Todd F. Glass

  3. Division of Emergency Medicine, Department of Pediatrics, Nemours Children’s Hospital, Orlando, FL, 32827, USA

    Yann B. Ferrand

Authors
  1. Duane Steward
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  2. Todd F. Glass
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  3. Yann B. Ferrand
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Correspondence to Duane Steward.

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Conflict of Interest

Duane Steward declares that he has no conflict of interest. Todd Glass declares that he has no conflict of interest. Yann Ferrand declares that he has no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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This article is part of the Topical Collection on Systems-Level Quality Improvement

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Steward, D., Glass, T.F. & Ferrand, Y.B. Simulation-Based Design of ED Operations with Care Streams to Optimize Care Delivery and Reduce Length of Stay in the Emergency Department. J Med Syst 41, 162 (2017). https://doi.org/10.1007/s10916-017-0804-6

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  • DOI: https://doi.org/10.1007/s10916-017-0804-6

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