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A Hybrid Simulation Approach to Analyse Patient Boarding in Emergency Departments

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Health Care Systems Engineering (ICHCSE 2017)

Part of the book series: Springer Proceedings in Mathematics & Statistics ((PROMS,volume 210))

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Abstract

This paper deals with the problem of patient boarding in Emergency Department (ED) due to the lack of availability of stay beds in inpatient hospital wards. The boarding of emergent patients is a major reason of ED overcrowding, which in turn creates long waiting times in ED, as well as patient and staff dissatisfaction. In this paper a hybrid simulation framework is proposed to describe how emergent and elective patients flows interact each other inside the hospital. The framework combines System Dynamics (SD) and Discrete Event Simulation (DES). Flows are generated at macro level by the SD model, while in DES model they are disentangled into single entities following a detailed process-oriented pathway. The hybrid model has been then applied and validated to data from a medium-size public hospital located in Genova (Italy). Furthermore, some metrics (such as waiting times to be admitted in hospital, number of trolleys in ED, inpatient bed occupancy rates and elective patients delayed) are proposed as key indicators to assess the system performance.

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Author information

Authors and Affiliations

  1. Medical School, University of Exeter, Exeter, UK

    Paolo Landa

  2. Department of Economics and Business Studies, University of Genova, Genoa, Italy

    Michele Sonnessa, Marina Resta, Elena Tànfani & Angela Testi

Authors
  1. Paolo Landa
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  2. Michele Sonnessa
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  3. Marina Resta
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  4. Elena Tànfani
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  5. Angela Testi
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Corresponding author

Correspondence to Michele Sonnessa .

Editor information

Editors and Affiliations

  1. Dipartimento di Ingegneria dell’Informazione, University of Florence, Florence, Italy

    Paola Cappanera

  2. Department of Industrial and Systems Engineering, University of Wisconsin–Madison, Madison, Wisconsin, USA

    Jingshan Li

  3. Department of Mechanical Engineering, Politecnico di Milano, Milan, Italy

    Andrea Matta

  4. Laboratoire Génie Industriel, École Centrale Paris, Châtenay-Malabry, France

    Evren Sahin

  5. OG Productie en Logistiek Leuven, Katholieke Universiteit Leuven, Leuven, Belgium

    Nico J. Vandaele

  6. Dipartimento di Ingegneria Industriale, University of Florence, Florence, Italy

    Filippo Visintin

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Landa, P., Sonnessa, M., Resta, M., Tànfani, E., Testi, A. (2017). A Hybrid Simulation Approach to Analyse Patient Boarding in Emergency Departments. In: Cappanera, P., Li, J., Matta, A., Sahin, E., Vandaele, N., Visintin, F. (eds) Health Care Systems Engineering. ICHCSE 2017. Springer Proceedings in Mathematics & Statistics, vol 210. Springer, Cham. https://doi.org/10.1007/978-3-319-66146-9_12

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