Simulation-based framework to improve patient experience in an emergency department
AbstractThe global economic crisis has a significant impact on healthcare resource provision worldwide. The management of limited healthcare resources is further challenged by the high level of uncertainty in demand, which can lead to unbalanced utilization of the available resources and a potential deterioration of patient satisfaction in terms of longer waiting times and perceived reduced quality of services. Therefore, healthcare managers require timely and accurate tools to optimize resource utility in a complex and ever-changing patient care process. An interactive simulation-based decision support framework is presented in this paper for healthcare process improvement. Complexity and different levels of variability within the process are incorporated into the process modeling phase, followed by developing a simulation model to examine the impact of potential alternatives. As a performance management tool, balanced scorecard (BSC) is incorporated within the framework to support continual and sustainable improvement by using strategic-linked performance measures and actions. These actions are evaluated by the simulation model developed, whilst the trade-off between objectives, though somewhat conflicting, is analysed by a preference model. The preference model is designed in an interactive and iterative process considering decision makers preferences regarding the selected key performance indicators (KPIs). A detailed implementation of the framework is demonstrated on an emergency department (ED) of an adult teaching hospital in north Dublin, Ireland. The results show that the unblocking of ED outflows by in-patient bed management is more effective than increasing only the ED physical capacity or the ED workforce.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Bibliographic InfoArticle provided by Elsevier in its journal European Journal of Operational Research.
Volume (Year): 224 (2013)
Issue (Month): 1 ()
Contact details of provider:
Web page: http://www.elsevier.com/locate/eor
Simulation; Multiple criteria decision analysis; Emergency department; Healthcare management;
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Kim, Seung-Chul & Horowitz, Ira & Young, Karl K. & Buckley, Thomas A., 1999. "Analysis of capacity management of the intensive care unit in a hospital," European Journal of Operational Research, Elsevier, vol. 115(1), pages 36-46, May.
- Wierzbicki, Andrzej P., 2007. "Modelling as a way of organising knowledge," European Journal of Operational Research, Elsevier, vol. 176(1), pages 610-635, January.
- Ahmed, Mohamed A. & Alkhamis, Talal M., 2009. "Simulation optimization for an emergency department healthcare unit in Kuwait," European Journal of Operational Research, Elsevier, vol. 198(3), pages 936-942, November.
- Brailsford, Sally & Vissers, Jan, 2011. "OR in healthcare: A European perspective," European Journal of Operational Research, Elsevier, vol. 212(2), pages 223-234, July.
- David Sinreich & Ola Jabali, 2007. "Staggered work shifts: a way to downsize and restructure an emergency department workforce yet maintain current operational performance," Health Care Management Science, Springer, vol. 10(3), pages 293-308, September.
- Litvak, Nelly & van Rijsbergen, Marleen & Boucherie, Richard J. & van Houdenhoven, Mark, 2008. "Managing the overflow of intensive care patients," European Journal of Operational Research, Elsevier, vol. 185(3), pages 998-1010, March.
- Saaty, Thomas L., 1990. "How to make a decision: The analytic hierarchy process," European Journal of Operational Research, Elsevier, vol. 48(1), pages 9-26, September.
- Kim, Soung-Hie & Jang, Ki-Jin, 2002. "Designing performance analysis and IDEF0 for enterprise modelling in BPR," International Journal of Production Economics, Elsevier, vol. 76(2), pages 121-133, March.
- Oddoye, J.P. & Jones, D.F. & Tamiz, M. & Schmidt, P., 2009. "Combining simulation and goal programming for healthcare planning in a medical assessment unit," European Journal of Operational Research, Elsevier, vol. 193(1), pages 250-261, February.
- James S. Dyer & Peter C. Fishburn & Ralph E. Steuer & Jyrki Wallenius & Stanley Zionts, 1992. "Multiple Criteria Decision Making, Multiattribute Utility Theory: The Next Ten Years," Management Science, INFORMS, vol. 38(5), pages 645-654, May.
- Liberatore, Matthew J. & Nydick, Robert L., 2008. "The analytic hierarchy process in medical and health care decision making: A literature review," European Journal of Operational Research, Elsevier, vol. 189(1), pages 194-207, August.
- Harper, P. R. & Shahani, A. K. & Gallagher, J. E. & Bowie, C., 2005. "Planning health services with explicit geographical considerations: a stochastic location-allocation approach," Omega, Elsevier, vol. 33(2), pages 141-152, April.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Zhang, Lei).
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.