Reducing emergency department overcrowding -five patient buffer concepts in comparison

Proceedings - Winter Simulation Conference

Volumn , Issue , 2008, Pages 1516-1525

  Kolb, Erik M W ^a   Peck, Jordan ^b   Schoening, Sebastian ^c   Lee, Taesik ^d  

^a RWTH AACHEN UNIVERSITY   (Germany)

^b MASSACHUSETTS INSTITUTE OF TECHNOLOGY   (United States)

^c MAG Europe GmbH   (Germany)

^d Korea Advanced Institute of Science and Technology (KAIST)   (South Korea)

Author keywords

[No Author keywords available]

Indexed keywords

DISCRETE-EVENT SIMULATIONS; EMERGENCY DEPARTMENTS; INPUT DATUM; MEDICAL CARES; PATIENT FLOWS; POTENTIAL IMPACTS; PROCESS FLOWS;

DISCRETE EVENT SIMULATION;

EMERGENCY ROOMS;

EID: 60749102938     PISSN: 08917736     EISSN: None     Source Type: Conference Proceeding    
DOI: 10.1109/WSC.2008.4736232     Document Type: Conference Paper

References (29)

1. Andrulis, D. P., A. Kellermann, E. A. Hintz, B. B. Hackman, and V. B. Weslowski. 1991. Emergency departments and crowding in United States teaching hospitals. Annals of Emergency Medicine 20:980-6.
2. Balci, O. 1995. Principles and Techniques of Simulation Validation, Verification, and Testing. Winter Simulation Conference Proceedings, 147-154.
3. Banks, J., J. Carson, B. Nelson, D. Nicol. 2005. Discreteevent system simulation - fourth edition. Pearson.
4. Bertoty, D. A., M. Kuszajewski, E. Marsh. 2007. Directto-room: one department's approach to improving ED throughput. Journal of Emergency Nursing 33:26-30.
5. Brewer, S. 2002. Study: clogged trauma care leads to deaths. Houston Chronicle. 3:A27. November 21, 2002.
6. Cowan, R., S. Trzeciak. 2005. Clinical review: Emergency department overcrowding and the potential impact on the critically ill. Critical Care 9:291-295.
7. Derlet, R. W., J. R. Richards, R. L. Kravitz. 2001. Frequent overcrowding in U.S. Emergency Departments. Academic Emergency Medicine 8:151-155.
8. Forster, A. J., 1. Stiell, G. Wells, A. Lee, C. van Walraven. 2003. The Effect of Hospital Occupancy on Emergency Department Length of Stay and Patient Disposition. Academic Emergency Medicine. 10:127-133.
9. Garcia, M. L. 1995. Reducing Time in an Emergency Room via a Fast-Track. Winter Simulation Conference Proceedings, 1048-1053.
10. Greene, J. 2007. Emergency department flow and the boarded patient: how to get admitted patients upstairs. Annals of Emergency Medicine 49:68-70.
11. Hoot, N. R., C. Zhou, 1. Jones, D. Aronsky. 2007. Measuring and Forecasting Emergency Department Crowding in Real Time. Annals of Emergency Medicine 49:747-755.
12. Jacobson, S. H., S. N. Hall, and J. R. Swisher. 2006. Discrete-Event Simulation of Healthcare Systems. In Patient Flow: Reducing Delay in Healthcare Delivery, ed. R. W. Hall, 211-252. Los Angeles: Springer.
13. Jones, S. S., T. L. Allen, T. J. Flottemesch, and S. J. Welch. 2006. An Independent Evaluation of Four Quantitative Emergency Department Crowding Scales. Academic Emergency Medicine 13:1204-1211.
14. Kelton, W. D., R. Sadowski, D. Sturrock. 2007. Simulation with Arena, fourth edition. McGrawHill: Boston.
15. Kolb, E. M. W. 2008. Emergency Department Crowding Analysis and Evaluation of Buffer Concepts by Predictive Discrete Event Simulation. Diplom thesis, Department of Mechanical Engineering, RWTH Aachen University, Germany.
16. Kolb, E. M. W., T. Lee, J. Peck. 2007. Effect of coupling between Emergency Department and Inpatient unit on the overcrowding in Emergency Department. Winter Simulation Conference Proceedings, 1586-1593.
17. Kowalczyk, L. 2007. At the ER, the stay can reach 8 hours - Loss of beds at major Bay State hospital is blamed. The Boston Globe. Al. March 25, 2007.
18. McCaig, L. F., C. W. Burt. 2004. National Hospital Ambulatory Medical Care Survey: 2002 emergency department summary. Advance Data 340:1-34.
19. Miro, O., M. Sanchez, G. Espinosa, B. Coll-Vinent, E. Bragulat, J. Milla, J. Wardrope. 2003. Analysis of patient flow in the emergency department and the effect of an extensive reorganization. Emergency Medicine Journal 20:143-148.
20. Rathlev, N. K., J. Chessare, J. Olshaker, D. Obendorfer, S. D. Mehta, T. Rothenhaus, S. Crespo, B. Magauran, K. Davidson, R. Shemin, K. Lewis, J. M. Becker, L. Fisher, L. Guy, A. Cooper, E. Litvak. 2007. Time Series Analysis of Variables Associated With Daily Mean Emergency Department Length of Stay. Annals of Emergency Medicine 49:265-271.
21. Richardson, D. B. 2006. Increase in patient mortality at 10 days associated with emergency department overcrowding. The Medical journal of Australia 124:213-216.
22. Richardson, T., R. Dick, S. Schneider. 2007. Evaluation of an Emergency Department Inpatient Observational Unit. Academic Emergency Medicine 14:S198
23. Sargent, R. G. 1999. Validation and Verification of Simulation Models. Winter Simulation Conference Proceedings, 39-48.
24. Schneider, S., F. Zwemer, A. Doniger, R. Dick, T. Czapranski. E. Davis. 2001. Rochester, New York: A Decade of Emergency Department Overcrowding. Annals of Emergency Medicine 8:1044-1050.
25. Subash, F., F. Dunn, B. McNicholl, J. Marlow. 2004. Team triage improves emergency department efficiency. Emergency Medicine Journal 21:542-544.
26. Schuil, M. J., K. Lazier, M. Vermeulen, S. Mawhinney, and L. J. Morrison. 2003. Emergency department contributors to ambulance diversion: A quantitative analysis. Annals of Emergency Medicine 41:467-476.
27. Schuil, M. J., A. Kiss, J.P. Szalai. 2007. The Effect of Low-Complexity Patients on Emergency Department Waiting Times. Annals of Emergency Medicine 49:257-264.
28. United States General Accounting Office (US GAO). 2003. Hospital Emergency Departments: Crowded Conditions Vary among Hospitals and Communities. Available via [accessed March 31, 2007].
29. Yancer, D. A., D. Foshee, H. Cole, R. Beauchamp, W. de 1a Pena, T. Keefe, W. Smith, K. Zimmerman, M. Lavine, B. Toops. 2006. Managing Capacity to Reduce Emergency Department Overcrowding and Ambulance Diversions. Joint Commission Journal on Quality and Patient Safety 32:239-245.