Effective Utilization of Ancillary Services to Reduce Patient Turnaround Times at an Emergency Room

摘要

The emergency room (or the ED) is a critical aspect of any hospital. A key parameter that can be used to judge customer satisfaction is the 'patient turnaround time' (or PTAT), which is the time that elapses between the arrival and the departure of a patient to an ED. The minimization of the PTAT has a dual advantage since it can improve customer satisfaction while concurrently increasing a hospital's revenue. Radiology and laboratory departments are among the most critical service-departments in a hospital. These departments often dedicate a portion of their resources to exclusively serve the ED. Test results from the ancillary departments are a key input when deciding the appropriate treatment for the patients admitted to the ED. The non-availability of test results may delay the treatment process, resulting in increased ED patient turnaround times. The objective of this research endeavor was to reduce the overall PTAT at an ED with a specific focus on the ancillary departments. The ED's functioning was carefully mapped and the different flow patterns of the patients, as categorized by the type of ailment and its criticality, were recorded. The role and effect of the services obtained from ancillary departments vis-a-vis the patient flow pattern were evaluated. Available data was studied and, if needed, additional data was collected. A baseline simulation model that effectively described the status of the ED was developed, tested, and validated. The time it took for ancillary departments to service requests from the ED was studied. Factors that enhanced this metric (turnaround time for the ancillary departments) were identified. Solution strategies, such as the reallocation of resources, alternate staffing patterns, cross-training of staff, and different routing procedures, were proposed and tested through simulation. The 'best' solutions were then selected and prioritized. Reductions in the turnaround times associated with requests made to ancillary departments (such as laboratories and the radiology department) resulted in a concomitant decrease in patient turnaround times in the ED.