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Hospital emergency
departments are having to cope with increasing pressures from competition,
reimbursement problems and healthcare reform. The hospital’s customers are
less willing to accept long waits in any department, but especially in the
Emergency department.
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Simulation was done
for a hospital where the average patient waiting time in the emergency
department was 157 minutes, significantly greater than the acceptable average
of 120 minutes.
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MedModel is a
healthcare industry-specific simulator package with some advantages over
other products. These advantages
include the ability to capture and release resources, the use of pathway
networks to allow resources to walk up and down hallways and through doors,
and graphical interactions.
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The first step was
to identify the process. In this case, the process was patient flow through
Emergency Services. The study would focus on all the steps occurring from the
time the patient entered the emergency department until the patient was
released, admitted to ward or transferred to another department
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The objective was to
reduce the patient’s length of stay. Each alternative could be tested
on-screen and evaluated for effectiveness.
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The model should be
planned and defined upfront, with the data collection requirements thoughout
and scheduled in advance. Failure to take the time to design the model is one
of the biggest reasons for projects not being completed on time.
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The need to have a
central database of information about patient visits became apparent. The
type of data needed for the study was the same data that is needed over and
over again to track progress and for assessment of current trends. 14
categories of patients were identified, flow charts were made for each type.
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The model included
17 resources, 4 entities, 29 shifts, 6 result files, 20 variables, 20
attributes, 1 array, 8 subroutines, 12 macros, 8 function tables, 2
distribution tables, 11 arrival cycle tables and patient processing and
routing logic
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(McGuire, 1994).
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