Modeling and Analysis of Emergency Department for Operational Improvements Using Discrete Event Simulation
Recent overcrowding trends in United States emergency departments has spurred various improvement initiatives which focus on reducing patient care time, increasing turnaround, and reducing exorbitant expenditures on vital medical services. Lean methodology, in particular, has become commonplace in healthcare, as its core idea of continuous improvement is universally accepted. For this reason, San Antonio's University Hospital is seeking opportunities for continuously improving their current emergency department systems, and to expedite the care of incoming patients while maintaining their exceptional level of care. The purpose of this thesis is to simulate the front-end operations of University Hospital's emergency department, using Rockwell Arena software, and to identify bottlenecks, examine patient throughput times, and suggest possibilities for improvement. Past publications of hospital emergency department improvement programs were studied and taken into consideration. Despite issues obtaining empirical data, the simulation proves viable. Missing data was derived from confirmed medical authorities, and resulted in a reliable simulation model from which various statistics can be generated with a user-friendly interface. The simulation leads to suggested improvement ideas with respect to high utilization for triage and for the front end doctor. These include adding a staff position to register patients instead of relying on the triage nurses for it, redirecting non-urgent patients to a nearby clinic, and implementing the use of voice to text software to speed up documentation processes.