This study describes a field observation study and use of simulation to quantify the effect of patient arrival rate and physician practices on physician idle time and patient wait time.
The observation study measured actual service (diagnosis, therapy, and charting) times for 126 patients.
Subsequently, a FORTRAN simulation model examined effects of physician practices and patient arrival rate on physician utilization and patient wait time.
Observations were taken in the emergency department of an urban, university-affiliated pediatric teaching hospital.
Although times for initial diagnostic evaluation (diagnosis), therapy, and charting averaged 13.3,13.8, and 11.6 minutes, respectively, maximum patient visits approached six hours.
The simulation model showed that, during times of frequent patient arrivals, maximum patient wait times increased greatly.
Additionally, the model predicted that physician idle time persists even during periods of frequent patient arrivals and long maximum visit times.
Emergency department (ED) senior staff (fellows and attendings) often begin treating new patients when current patients leave for tests external to the ED.
This practice increases physician utilization and makes more physician capacity available, but it may lead to small additional patient waits if the physician is treating another patient when the first patient returns from the external test before their original physician becomes free. (...)
Mots-clés Pascal : Service urgence, Centre hospitalier universitaire, Gestion ressources, Planification, Temps attente, Temps traitement, Temps parcours, Expérience professionnelle, Etats Unis, Amérique du Nord, Amérique, Organisation système, Modèle simulation, Logistique, Enfant, Homme, Service santé
Mots-clés Pascal anglais : Emergency department, Teaching hospital, Resource management, Planning, Waiting time, Processing time, Transit time, Professional experience, United States, North America, America, System configuration, Simulation model, Logistics, Child, Human, Health service
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0154740
Code Inist : 002B27B14C. Création : 21/07/1998.