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Improving emergency department performance by revising the patient–physician assignment process

Author

Listed:
  • Lien Vanbrabant

    (UHasselt
    Research Foundation Flanders (FWO))

  • Kris Braekers

    (UHasselt)

  • Katrien Ramaekers

    (UHasselt)

Abstract

Emergency departments (EDs) are continuously exploring opportunities to improve their efficiency. A new opportunity lies in revising the patient–physician assignment process by limiting the number of patients simultaneously assigned to a single physician, which is defined as the application of a case manager approach with limited caseloads. The potential of introducing a case manager approach with limited caseloads as a way to improve physician productivity, and consequently ED performance, is investigated by use of a discrete-event simulation model based on a real-life case study. In addition, as the case manager system is characterised by three parameters that can be customised and optimised (i.e. caseload limit, pre-assignment queueing discipline and internal queueing discipline), the impact of these parameters on the effectiveness to improve ED performance in terms of length-of-stay and door-to-doctor time is evaluated. To the best of our knowledge, this paper is the first to examine the potential of a case manager system with limited caseloads in a complex service system like a real-life ED, and to investigate the impact of the three system parameters on the results. The outcomes of the study show that performance can be improved significantly by introducing a case manager system, and that the system parameters have an impact on the effect size.

Suggested Citation

  • Lien Vanbrabant & Kris Braekers & Katrien Ramaekers, 2021. "Improving emergency department performance by revising the patient–physician assignment process," Flexible Services and Manufacturing Journal, Springer, vol. 33(3), pages 783-845, September.
    • Handle: RePEc:spr:flsman:v:33:y:2021:i:3:d:10.1007_s10696-020-09388-2
    DOI: 10.1007/s10696-020-09388-2
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    References listed on IDEAS

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