Publication Type
Journal Article
Version
acceptedVersion
Publication Date
9-2016
Abstract
Long waiting times in emergency departments (EDs) not only reduce patients’ perceived quality of care, but also increase crowding which can adversely affect patients’ outcomes. Waiting time has been found to affect patients’ outcomes and is closely associated with delays in the provision of ancillary services to ED patients by the diagnostic/treatment laboratories. The focus of this study is to improve the flow of ED patients by testing alternative triage processes and capacity of physicians, triage nurses and laboratories. Three alternative triage processes are examined for managing the flow of ED patients through shared and dedicated laboratories across different utilization of physicians, triage nurses, and laboratories using a discrete event simulation (DES) model that captures the pertinent characteristics of EDs operating in tertiary acute care hospitals under conservative assumptions. Our results show that choosing the appropriate triage process and adding extra capacity to the triage and dedicated laboratory can significantly improve ED performance, especially when physician utilization is high. In contrast, adding extra capacity to a shared laboratory improves performance only slightly. Our results also show that shared laboratory generally provides better support to EDs than dedicated laboratory.
Keywords
Emergency department, Triaging, Healthcare quality improvement, Simulation
Discipline
Medicine and Health Sciences | Operations and Supply Chain Management
Research Areas
Operations Management
Publication
Operations Research for Health Care
Volume
10
First Page
13
Last Page
22
ISSN
2211-6923
Identifier
10.1016/j.orhc.2016.05.001
Publisher
Elsevier
Citation
YANG, Kum Khiong; LAM, Sean Shao Wei; LOW, Joyce M. W.; and ONG, Marcus Eng Hock.
Managing emergency department crowding through improved triaging and resource allocation. (2016). Operations Research for Health Care. 10, 13-22.
Available at: https://ink.library.smu.edu.sg/lkcsb_research/4945
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Additional URL
https://doi.org/10.1016/j.orhc.2016.05.001