Jeffrey Che-Hung Tsai1, Shao-Jen Weng2,3, Shih-Chia Liu2,3, Yao-Te Tsai4, Donald F Gotcher5, Chih-Hao Chen2, Chun-An Chou6, Seung-Hwan Kim7. 1. Department of Emergency Medicine, Taichung Veterans General Hospital, Puli Brach, Nantou 54552, Taiwan. 2. Department of Industrial Engineering and Enterprise Information, Tunghai University, Taichung 40799, Taiwan. 3. Healthcare Systems Consortium, Tunghai University, Taichung 40704, Taiwan. 4. Department of International Business, Feng Chia University, Taichung 40723, Taiwan. 5. Department of International Business, Tunghai University, Taichung 40704, Taiwan. 6. Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA, 02115, USA. 7. Department of Business Administration, Ajou University, Suwon 443-749, Korea.
Abstract
STUDY OBJECTIVE: Overcrowding in emergency departments (ED) is an increasingly common problem in Taiwanese hospitals, and strategies to improve efficiency are in demand. We propose a bed resource allocation strategy to overcome the overcrowding problem. METHOD: We investigated ED occupancy using discrete-event simulation and evaluated the effects of suppressing day-to-day variations in ED occupancy by adjusting the number of empty beds per day. Administrative data recorded at the ED of Taichung Veterans General Hospital (TCVGH) in Taiwan with 1500 beds and an annual ED volume of 66,000 visits were analyzed. Key indices of ED quality in the analysis were the length of stay and the time in waiting for outward transfers to in-patient beds. The model is able to analyze and compare several scenarios for finding a feasible allocation strategy. RESULTS: We compared several scenarios, and the results showed that by reducing the allocated beds for the ED by 20% on weekdays, the variance of daily ED occupancy was reduced by 36.25% (i.e., the percentage of reduction in standard deviation). CONCLUSIONS: This new allocation strategy was able to both reduce the average ED occupancy and maintain the ED quality indices.
STUDY OBJECTIVE: Overcrowding in emergency departments (ED) is an increasingly common problem in Taiwanese hospitals, and strategies to improve efficiency are in demand. We propose a bed resource allocation strategy to overcome the overcrowding problem. METHOD: We investigated ED occupancy using discrete-event simulation and evaluated the effects of suppressing day-to-day variations in ED occupancy by adjusting the number of empty beds per day. Administrative data recorded at the ED of Taichung Veterans General Hospital (TCVGH) in Taiwan with 1500 beds and an annual ED volume of 66,000 visits were analyzed. Key indices of ED quality in the analysis were the length of stay and the time in waiting for outward transfers to in-patient beds. The model is able to analyze and compare several scenarios for finding a feasible allocation strategy. RESULTS: We compared several scenarios, and the results showed that by reducing the allocated beds for the ED by 20% on weekdays, the variance of daily ED occupancy was reduced by 36.25% (i.e., the percentage of reduction in standard deviation). CONCLUSIONS: This new allocation strategy was able to both reduce the average ED occupancy and maintain the ED quality indices.
Entities:
Keywords:
discrete-event simulation; emergency department operations; inpatient bed allocation; overcrowding
Authors: Jesús Isaac Vázquez-Serrano; Rodrigo E Peimbert-García; Leopoldo Eduardo Cárdenas-Barrón Journal: Int J Environ Res Public Health Date: 2021-11-22 Impact factor: 3.390