Designing patient flow in emergency departments

Yariv N. Marmor, Boaz Golany, Shlomo Israelit, Avishai Mandelbaum

Research output: Contribution to journalArticlepeer-review

Abstract

Emergency Department (ED) managers can choose from several operational models, for example, Triage or Fast-Track. The following questions thus naturally arise: why does a hospital choose to work with its particular operational model rather than another? Or what is the best model to operate under? More specifically, how to fit an operational model to an ED's uncontrollable (environmental) parameters? To address such questions, we develop a methodology for ED Design (EDD): we apply it to data collected over a period of two to four years from eight hospitals, of various sizes and deploying various ED operational models. (To cover all size-model combinations, we enrich our data via accurate ED simulation.) The EDD methodology first feeds the data into a Data Envelopment Analysis (DEA) program, which determines the relative efficiency of each month of the different operational models of each hospital. Then, after taking into account the individual hospitals effect, we identify the operational model that is dominant under each set of uncontrollable parameters. We discovered that different operational models dominate others over different combinations of uncontrollable parameters. For example, a hospital catering to an aging population is best served by a fast-track operational model.

Original languageEnglish
Pages (from-to)233-247
Number of pages15
JournalIIE Transactions on Healthcare Systems Engineering
Volume2
Issue number4
DOIs
StatePublished - Oct 2012

Keywords

  • Fast Track
  • Patient flow
  • Triage
  • data envelopment analysis (DEA)
  • discrete-event simulation
  • efficiency
  • emergency department (ED)
  • operational model

ASJC Scopus subject areas

  • Safety, Risk, Reliability and Quality
  • Safety Research
  • Public Health, Environmental and Occupational Health

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