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University of Louisville Hospital Emergency Department Simulation, how to improve patient satisfaction and increase ED's revenue

Haas, Eddy de (2010) University of Louisville Hospital Emergency Department Simulation, how to improve patient satisfaction and increase ED's revenue.

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Abstract:The University of Louisville Hospital Emergency Department (UofL Hospital ED) is experiencing problems with the large (and increasing) number of patients coming in. Due to hospital space limit, it is almost impossible to expand the number of ED beds. So other solutions need to be found to cope with these extra patients. In order to find solutions without actually affecting the daily operations of the Emergency Department, a simulation model is developed and different ED options are investigated. The following options are investigated: 1. a physician and a nurse see the patient together when both a nurse and a physician are available 2. hire a nurse that is dedicated to discharging and admitting patients 3. make extra beds available in the hospital where patients can be held to wait when the decision is made that they are going to be admitted to the hospital 4. hire some nurses until 8pm instead of 7pm 5. the following combinations of the above stated options; 1 + 2, 1 + 3, 2 + 3 and 1 + 2 + 3. All options shown above are also investigated with one more nurse than what is the case at the moment. In order to find out what the impact of all options can be, all options are simulated with arrival rates varying from the current arrival rate to a 20% higher arrival rate than the current one, in steps of 2.5% The results indicate that the best option to implement is the combination of 1 + 2 + 3 and the extra nurse. This will make it possible to have more revenue without having to invest significant amounts of money. This combination also is the safest choice to implement, because when one of the options turns out not to work as expected, the other changes will probably make sure that extra revenue can made after. A problem that is not investigated using the simulation model but that may have its influence on the process and throughput times at the ED is the fact that around the nurse shift changes in the hospital, the number of people that are put in their assigned bed (when they are going to be admitted to the hospital) drastically decreases. This cannot be explained by anything other than human behavior not wanting to have extra work at the end of a shift. This causes patients to stay longer at ED than necessary and makes it impossible for new patients to enter the ED faster. A solution for this problem may be to spread the moments that nurses start working at the hospital.
Item Type:Internship Report (Master)
University of Louisville, USA
Faculty:ET: Engineering Technology
Subject:52 mechanical engineering
Programme:Mechanical Engineering MSc (60439)
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