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Discrete-event simulation and design of experiments to study ambulatory patient waiting time in an emergency department

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  • Chantal Baril
  • Viviane Gascon
  • Dominic Vadeboncoeur

Abstract

Despite major investments in healthcare, access to front line health services (family doctors, walk-in clinics) is still difficult. If front line healthcare services remain insufficient, emergency departments will have to offer non-urgent patients appropriate services. More than half of emergency patients are ambulatory patients and their medical condition is not usually as serious as for patients on stretchers (Thibeault, 2014). This paper is devoted to the analysis of ambulatory patient length of stay in an emergency department of a hospital in the province of Quebec. The average length of stay for ambulatory patients in that hospital is slightly more than 7 hours which exceeds the average 4 hours observed for all emergency departments in Quebec. To identify the factors and their interactions affecting the performance of the hospital emergency, measured by the average length of stay for ambulatory patients, experimental design and discrete-event simulation were used. This research aims at verifying how nurses can contribute to reduce emergency department overcrowding. Our results show that giving more responsibility to nurses (collective prescriptions, review patients) reduce greatly the average patient length of stay with less financial effort than adding new doctors. This allows doctors to focus on the more acute patients.

Suggested Citation

  • Chantal Baril & Viviane Gascon & Dominic Vadeboncoeur, 2019. "Discrete-event simulation and design of experiments to study ambulatory patient waiting time in an emergency department," Journal of the Operational Research Society, Taylor & Francis Journals, vol. 70(12), pages 2019-2038, December.
    • Handle: RePEc:taf:tjorxx:v:70:y:2019:i:12:p:2019-2038
    DOI: 10.1080/01605682.2018.1510805
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    Cited by:

    1. You-Xuan Lin & Chi-Hao Lin & Chih-Hao Lin, 2021. "A challenge for healthcare system resilience after an earthquake: The crowdedness of a first-aid hospital by non-urgent patients," PLOS ONE, Public Library of Science, vol. 16(4), pages 1-16, April.
    2. 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.
    3. Gouveia, Catarina & Kalakou, Sofia & Cardoso-Grilo, Teresa, 2023. "How to forecast mental healthcare needs? Distinguishing between perceived and unperceived needs and their impact on capacity requirements," Socio-Economic Planning Sciences, Elsevier, vol. 87(PA).
    4. Miguel Ortiz-Barrios & Juan-José Alfaro-Saiz, 2020. "An integrated approach for designing in-time and economically sustainable emergency care networks: A case study in the public sector," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-28, June.

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