Across the country ambulances are turned away from emergency departments (EDs) and patients are waiting hours and sometimes days to be admitted to a hospital room. Hospitals are finding it hard to get specialist physicians to come to treat emergency patients. Our EDs demand a new way of thinking. They are not at a tipping point; they are at a break

Optimizing patient flow : advanced strategies for managing variability to enhance access, quality, and safety offers readers innovate techniques for maximizing patient flow and improving operations management while providing clear examples of successful impementation. This all-new book can help health care organizations to reduce and manage variability, thereby increasing the reliablity of systems and processes and improving health care quality and safety.

In this study, we have aimed to optimize patient flow in emergency departments while minimizing associated costs. In order to be able to compare the effect of any changes, we developed a simulation model for an emergency department using Queuing theory, and regarding the optimization we utilized Genetic Algorithm to find the best change. Basically, we have designed a Discrete Event based, multi-class, multi-server queuing network as we have considered the emergency department a set of stages associated with a queue of patients waiting to be served. Each stage has multiple service providers such as Nurses, Doctors or other staff. We also classified patients passing through the stages, according to their acuity level and personal characteristics. Then, we defined a function as a measure of the ED performance in respect to the calculated wait times and the cost. Finally, we developed a customized genetic algorithm to find the best performance which reflects the best allocation of service providers into multiple stages of the emergency department.

Written for a global audience, by an international team, the book provides practical, case-based emergency department leadership skills.

Provides hospitals with scientifically grounded methods to optimally manage patient flow. This title features advanced tutorials to help you to: understand the problems in patient flow management; assess the quantitative impact of patient flow issues on patients and staff; and, use quantitative methods to enhance patient flow.

This book is dedicated to improving healthcare through reducing delays experienced by patients. With an interdisciplinary approach, this new edition, divided into five sections, begins by examining healthcare as an integrated system. Chapter 1 provides a hierarchical model of healthcare, rising from departments, to centers, regions and the “macro system.” A new chapter demonstrates how to use simulation to assess the interaction of system components to achieve performance goals, and Chapter 3 provides hands-on methods for developing process models to identify and remove bottlenecks, and for developing facility plans. Section 2 addresses crowding and the consequences of delay. Two new chapters (4 and 5) focus on delays in emergency departments, and Chapter 6 then examines medical outcomes that result from waits for surgeries. Section 3 concentrates on management of demand. Chapter 7 presents breakthrough strategies that use real-time monitoring systems for continuous improvement. Chapter 8 looks at the patient appointment system, particularly through the approach of advanced access. Chapter 9 concentrates on managing waiting lists for surgeries, and Chapter 10 examines triage outside of emergency departments, with a focus on allied health programs Section 4 offers analytical tools and models to support analysis of patient flows. Chapter 11 offers techniques for scheduling staff to match patterns in patient demand. Chapter 12 surveys the literature on simulation modeling, which is widely used for both healthcare design and process improvement. Chapter 13 is new and demonstrates the use of process mapping to represent a complex regional trauma system. Chapter 14 provides methods for forecasting demand for healthcare on a region-wide basis. Chapter 15 presents queueing theory as a method for modeling waits in healthcare, and Chapter 16 focuses on rapid delivery of medication in the event of a catastrophic event. Section 5 focuses on achieving change. Chapter 17 provides a diagnostic for assessing the state of a hospital and using the state assessment to select improvement strategies. Chapter 18 demonstrates the importance of optimizing care as patients transition from one care setting to the next. Chapter 19 is new and shows how to implement programs that improve patient satisfaction while also improving flow. Chapter 20 illustrates how to evaluate the overall portfolio of patient diagnostic groups to guide system changes, and Chapter 21 provides project management tools to guide the execution of patient flow projects.

Over the past several years there has been an overwhelming amount of patients coming to the emergency department for medical care. It is essential for all emergency departments to improve patient flow by identifying barriers that slow the patient flow down and improve and revise these areas. The research study was done to identify multiple areas causing issues with patient flow through emergency departments.