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A discrete event simulation approach for reserving capacity for emergency patients in the radiology department

机译:一种离散事件模拟方法来保留放射科急诊患者的能力

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Many hospitals in China experience large volumes of emergency department (ED) radiology patients, thereby lengthening the wait times for non-emergency radiology patients. We examine whether an emergency reservation policy which deals with stochastic arrivals of ED patients can shorten wait times, and what effect it has on patient and hospital related metrics. In this study, operations research models are used to develop an emergency reservation policy. First, we construct a discrete event simulation (DES) model based on the process of patients served by one computed tomography (CT) scanner at West China Hospital (WCH). Next, a newsvendor model is built to compute the daily reservation quantity for emergency patients. Based on the appointment scheduling rule and daily emergency reservation policies, the effects of the proposed policy on daily examination quantity, patient wait times, and equipment utilization are explicitly modeled. Finally, we evaluate the impact of different reservation policies on these system performance measures. Our analysis indicates that reserving capacity for emergency patients greatly shortens the delay for non-emergency patients with an average 43.9% reduction in total wait times. The pre-model utilization and average post-model utilization are 99.3% and 98.5%, respectively. In addition, the comparison of different reservation policies shows that there is no significant difference between any two policies in terms of patients’ wait times. Reserving proper capacity for emergency patients not only positively affects the patients’ delay times, but also affects various aspects of the hospital. Our goal is to design a simple and implementable emergency reservation policy. DES proves to be an effective tool for studying the effects of proposed scenarios to optimize capacity allocation in radiology management.
机译:中国许多医院都有大量急诊放射科病人,从而延长了非急诊放射科病人的等待时间。我们研究处理急诊病人随机到达的紧急保留政策是否可以缩短等待时间,以及它对病人和医院相关指标的影响。在这项研究中,运筹学模型用于制定应急储备政策。首先,我们根据华西医院(WCH)的一台计算机断层扫描(CT)扫描仪为患者服务的过程,构建了离散事件模拟(DES)模型。接下来,建立一个新闻供应商模型来计算急诊患者的每日预订量。基于约会调度规则和每日紧急预约策略,显式地模拟了所提议策略对每日检查数量,患者等待时间和设备利用率的影响。最后,我们评估了不同预留策略对这些系统性能指标的影响。我们的分析表明,为急诊患者保留的能力大大缩短了非急诊患者的延误时间,平均总等待时间减少了43.9%。模型前利用率和模型后平均利用率分别为99.3%和98.5%。此外,对不同保留政策的比较表明,就患者的等待时间而言,任何两个政策之间都没有显着差异。为急诊患者保留适当的容量不仅会积极影响患者的延误时间,而且还会影响医院的各个方面。我们的目标是设计一个简单且可实施的紧急保留政策。事实证明,DES是研究提议方案的效果的有效工具,以优化放射学管理中的容量分配。

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