IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v17y2020i8p2664-d344932.html
   My bibliography  Save this article

Methodological Approaches to Support Process Improvement in Emergency Departments: A Systematic Review

Author

Listed:
  • Miguel Angel Ortíz-Barrios

    (Department of Industrial Management, Agroindustry and Operations, Universidad de la Costa CUC, Barranquilla 081001, Colombia)

  • Juan-José Alfaro-Saíz

    (Research Centre on Production Management and Engineering, Universitat Politècnica de València, 46022 Valencia, Spain)

Abstract

The most commonly used techniques for addressing each Emergency Department (ED) problem (overcrowding, prolonged waiting time, extended length of stay, excessive patient flow time, and high left-without-being-seen (LWBS) rates) were specified to provide healthcare managers and researchers with a useful framework for effectively solving these operational deficiencies. Finally, we identified the existing research tendencies and highlighted opportunities for future work. We implemented the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology to undertake a review including scholarly articles published between April 1993 and October 2019. The selected papers were categorized considering the leading ED problems and publication year. Two hundred and three (203) papers distributed in 120 journals were found to meet the inclusion criteria. Furthermore, computer simulation and lean manufacturing were concluded to be the most prominent approaches for addressing the leading operational problems in EDs. In future interventions, ED administrators and researchers are widely advised to combine Operations Research (OR) methods, quality-based techniques, and data-driven approaches for upgrading the performance of EDs. On a different tack, more interventions are required for tackling overcrowding and high left-without-being-seen rates.

Suggested Citation

  • Miguel Angel Ortíz-Barrios & Juan-José Alfaro-Saíz, 2020. "Methodological Approaches to Support Process Improvement in Emergency Departments: A Systematic Review," IJERPH, MDPI, vol. 17(8), pages 1-41, April.
  • Handle: RePEc:gam:jijerp:v:17:y:2020:i:8:p:2664-:d:344932
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/17/8/2664/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/1660-4601/17/8/2664/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Manel Saad Saoud & Abdelhak Boubetra & Safa Attia, 2016. "A Simulation Knowledge Extraction-based Decision Support System for the Healthcare Emergency Department," International Journal of Healthcare Information Systems and Informatics (IJHISI), IGI Global, vol. 11(2), pages 19-37, April.
    2. Kaushal, Arjun & Zhao, Yuancheng & Peng, Qingjin & Strome, Trevor & Weldon, Erin & Zhang, Michael & Chochinov, Alecs, 2015. "Evaluation of fast track strategies using agent-based simulation modeling to reduce waiting time in a hospital emergency department," Socio-Economic Planning Sciences, Elsevier, vol. 50(C), pages 18-31.
    3. David Sinreich & Ola Jabali, 2007. "Staggered work shifts: a way to downsize and restructure an emergency department workforce yet maintain current operational performance," Health Care Management Science, Springer, vol. 10(3), pages 293-308, September.
    4. Eva K. Lee & Hany Y. Atallah & Michael D. Wright & Eleanor T. Post & Calvin Thomas & Daniel T. Wu & Leon L. Haley, 2015. "Transforming Hospital Emergency Department Workflow and Patient Care," Interfaces, INFORMS, vol. 45(1), pages 58-82, February.
    5. Kuang Xu & Carri W. Chan, 2016. "Using Future Information to Reduce Waiting Times in the Emergency Department via Diversion," Manufacturing & Service Operations Management, INFORMS, vol. 18(3), pages 314-331, July.
    6. Mustafa Y. Sir & David Nestler & Thomas Hellmich & Devashish Das & Michael J. Laughlin & Michon C. Dohlman & Kalyan Pasupathy, 2017. "Optimization of Multidisciplinary Staffing Improves Patient Experiences at the Mayo Clinic," Interfaces, INFORMS, vol. 47(5), pages 425-441, October.
    7. Courtad, Brenda & Baker, Kenneth & Magazine, Michael & Polak, George, 2017. "Minimizing flowtime for paired tasks," European Journal of Operational Research, Elsevier, vol. 259(3), pages 818-828.
    8. Elpidio Romano & Guido Guizzi & Daniela Chiocca, 2015. "A decision support tool, implemented in a system dynamics model, to improve the effectiveness in the hospital emergency department," International Journal of Procurement Management, Inderscience Enterprises Ltd, vol. 8(1/2), pages 141-168.
    9. Soraia Oueida & Yehia Kotb & Seifedine Kadry & Sorin Ionescu, 2018. "Healthcare Operation Improvement Based on Simulation of Cooperative Resource Preservation Nets for None-Consumable Resources," Complexity, Hindawi, vol. 2018, pages 1-14, November.
    10. Yen-Yi Feng & I-Chin Wu & Tzu-Li Chen, 2017. "Stochastic resource allocation in emergency departments with a multi-objective simulation optimization algorithm," Health Care Management Science, Springer, vol. 20(1), pages 55-75, March.
    11. Xiaoqing Wang, 2013. "Emergency Department Staffing: A Separated Continuous Linear Programming Approach," Mathematical Problems in Engineering, Hindawi, vol. 2013, pages 1-8, October.
    12. Umble, Michael & Umble, Elisabeth J., 2006. "Utilizing buffer management to improve performance in a healthcare environment," European Journal of Operational Research, Elsevier, vol. 174(2), pages 1060-1075, October.
    13. Izady, Navid & Worthington, Dave, 2012. "Setting staffing requirements for time dependent queueing networks: The case of accident and emergency departments," European Journal of Operational Research, Elsevier, vol. 219(3), pages 531-540.
    14. Virginia Ahalt & Nilay Tanık Argon & Serhan Ziya & Jeff Strickler & Abhi Mehrotra, 2018. "Comparison of emergency department crowding scores: a discrete-event simulation approach," Health Care Management Science, Springer, vol. 21(1), pages 144-155, March.
    15. Abo-Hamad, Waleed & Arisha, Amr, 2013. "Simulation-based framework to improve patient experience in an emergency department," European Journal of Operational Research, Elsevier, vol. 224(1), pages 154-166.
    16. Andersen, Anders Reenberg & Nielsen, Bo Friis & Reinhardt, Line Blander & Stidsen, Thomas Riis, 2019. "Staff optimization for time-dependent acute patient flow," European Journal of Operational Research, Elsevier, vol. 272(1), pages 94-105.
    17. David Sinreich & Ola Jabali & Nico Dellaert, 2012. "Reducing emergency department waiting times by adjusting work shifts considering patient visits to multiple care providers," IISE Transactions, Taylor & Francis Journals, vol. 44(3), pages 163-180.
    18. Ali Azadeh & Fatemeh Rouhollah & Fatemeh Davoudpour & Iraj Mohammadfam, 2013. "Fuzzy modelling and simulation of an emergency department for improvement of nursing schedules with noisy and uncertain inputs," International Journal of Services and Operations Management, Inderscience Enterprises Ltd, vol. 15(1), pages 58-77.
    19. Shuangchi He & Melvyn Sim & Meilin Zhang, 2019. "Data-Driven Patient Scheduling in Emergency Departments: A Hybrid Robust-Stochastic Approach," Management Science, INFORMS, vol. 65(9), pages 4123-4140, September.
    20. Bokhorst, Jos A.C. & van der Vaart, Taco, 2018. "Acute medical unit design – The impact of rearranged patient flows," Socio-Economic Planning Sciences, Elsevier, vol. 62(C), pages 75-83.
    21. Leo, Gianmaria & Lodi, Andrea & Tubertini, Paolo & Di Martino, Mirko, 2016. "Emergency Department Management in Lazio, Italy," Omega, Elsevier, vol. 58(C), pages 128-138.
    22. A. J. Thomas Schneider & P. Luuk Besselink & Maartje E. Zonderland & Richard J. Boucherie & Wilbert B. van den Hout & Job Kievit & Paul Bilars & A. Jaap Fogteloo & Ton J. Rabelink, 2018. "Allocating Emergency Beds Improves the Emergency Admission Flow," Interfaces, INFORMS, vol. 48(4), pages 384-394, August.
    23. Omar EL-Rifai & Thierry Garaix & Vincent Augusto & Xiaolan Xie, 2015. "A stochastic optimization model for shift scheduling in emergency departments," Health Care Management Science, Springer, vol. 18(3), pages 289-302, September.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Niyirora, Jerome & Zhuang, Jun, 2017. "Fluid approximations and control of queues in emergency departments," European Journal of Operational Research, Elsevier, vol. 261(3), pages 1110-1124.
    2. Duma, Davide & Aringhieri, Roberto, 2023. "Real-time resource allocation in the emergency department: A case study," Omega, Elsevier, vol. 117(C).
    3. Hainan Guo & David Goldsman & Kwok-Leung Tsui & Yu Zhou & Shui-Yee Wong, 2016. "Using simulation and optimisation to characterise durations of emergency department service times with incomplete data," International Journal of Production Research, Taylor & Francis Journals, vol. 54(21), pages 6494-6511, November.
    4. Omar EL-Rifai & Thierry Garaix & Vincent Augusto & Xiaolan Xie, 2015. "A stochastic optimization model for shift scheduling in emergency departments," Health Care Management Science, Springer, vol. 18(3), pages 289-302, September.
    5. Hainan Guo & Haobin Gu & Yu Zhou & Jiaxuan Peng, 2022. "A data-driven multi-fidelity simulation optimization for medical staff configuration at an emergency department in Hong Kong," Flexible Services and Manufacturing Journal, Springer, vol. 34(2), pages 238-262, June.
    6. David Scheinker & Margaret L. Brandeau, 2020. "Implementing Analytics Projects in a Hospital: Successes, Failures, and Opportunities," Interfaces, INFORMS, vol. 50(3), pages 176-189, May.
    7. Acuna, Jorge A. & Zayas-Castro, José L. & Charkhgard, Hadi, 2020. "Ambulance allocation optimization model for the overcrowding problem in US emergency departments: A case study in Florida," Socio-Economic Planning Sciences, Elsevier, vol. 71(C).
    8. Miguel Angel Ortíz-Barrios & Dayana Milena Coba-Blanco & Juan-José Alfaro-Saíz & Daniela Stand-González, 2021. "Process Improvement Approaches for Increasing the Response of Emergency Departments against the COVID-19 Pandemic: A Systematic Review," IJERPH, MDPI, vol. 18(16), pages 1-31, August.
    9. Wang, Fan & Zhang, Chao & Zhang, Hui & Xu, Liang, 2021. "Short-term physician rescheduling model with feature-driven demand for mental disorders outpatients," Omega, Elsevier, vol. 105(C).
    10. Erhard, Melanie & Schoenfelder, Jan & Fügener, Andreas & Brunner, Jens O., 2018. "State of the art in physician scheduling," European Journal of Operational Research, Elsevier, vol. 265(1), pages 1-18.
    11. Na Li & Xiaorui Li & Paul Forero, 2022. "Physician scheduling for outpatient department with nonhomogeneous patient arrival and priority queue," Flexible Services and Manufacturing Journal, Springer, vol. 34(4), pages 879-915, December.
    12. Ran Liu & Xiaolan Xie, 2018. "Physician Staffing for Emergency Departments with Time-Varying Demand," INFORMS Journal on Computing, INFORMS, vol. 30(3), pages 588-607, August.
    13. Pazoki, Mostafa & Samarghandi, Hamed, 2021. "Regulating patient care in walk-in clinics," Omega, Elsevier, vol. 99(C).
    14. Alberto De Santis & Tommaso Giovannelli & Stefano Lucidi & Mauro Messedaglia & Massimo Roma, 2020. "An optimal non-uniform piecewise constant approximation for the patient arrival rate for a more efficient representation of the Emergency Departments arrival process," DIAG Technical Reports 2020-01, Department of Computer, Control and Management Engineering, Universita' degli Studi di Roma "La Sapienza".
    15. Rostami-Tabar, Bahman & Ziel, Florian, 2022. "Anticipating special events in Emergency Department forecasting," International Journal of Forecasting, Elsevier, vol. 38(3), pages 1197-1213.
    16. Amir Elalouf & Guy Wachtel, 2022. "Queueing Problems in Emergency Departments: A Review of Practical Approaches and Research Methodologies," SN Operations Research Forum, Springer, vol. 3(1), pages 1-46, March.
    17. Tohidi, Mohammad & Kazemi Zanjani, Masoumeh & Contreras, Ivan, 2021. "A physician planning framework for polyclinics under uncertainty," Omega, Elsevier, vol. 101(C).
    18. Guihua Wang, 2022. "The Effect of Medicaid Expansion on Wait Time in the Emergency Department," Management Science, INFORMS, vol. 68(9), pages 6648-6665, September.
    19. Chang Wook Kang & Muhammad Imran & Muhammad Omair & Waqas Ahmed & Misbah Ullah & Biswajit Sarkar, 2019. "Stochastic-Petri Net Modeling and Optimization for Outdoor Patients in Building Sustainable Healthcare System Considering Staff Absenteeism," Mathematics, MDPI, vol. 7(6), pages 1-26, June.
    20. Jesús Isaac Vázquez-Serrano & Rodrigo E. Peimbert-García & Leopoldo Eduardo Cárdenas-Barrón, 2021. "Discrete-Event Simulation Modeling in Healthcare: A Comprehensive Review," IJERPH, MDPI, vol. 18(22), pages 1-20, November.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:17:y:2020:i:8:p:2664-:d:344932. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.