Rismanchian Farhood, Lee Young Hoon
1 Department of Information and Industrial Engineering, Yonsei University, Seoul, South Korea.
HERD. 2017 Jul;10(4):105-120. doi: 10.1177/1937586716674471. Epub 2016 Nov 29.
This article proposes an approach to help designers analyze complex care processes and identify the optimal layout of an emergency department (ED) considering several objectives simultaneously. These objectives include minimizing the distances traveled by patients, maximizing design preferences, and minimizing the relocation costs.
Rising demand for healthcare services leads to increasing demand for new hospital buildings as well as renovating existing ones. Operations management techniques have been successfully applied in both manufacturing and service industries to design more efficient layouts. However, high complexity of healthcare processes makes it challenging to apply these techniques in healthcare environments.
Process mining techniques were applied to address the problem of complexity and to enhance healthcare process analysis. Process-related information, such as information about the clinical pathways, was extracted from the information system of an ED. A goal programming approach was then employed to find a single layout that would simultaneously satisfy several objectives.
The layout identified using the proposed method improved the distances traveled by noncritical and critical patients by 42.2% and 47.6%, respectively, and minimized the relocation costs.
This study has shown that an efficient placement of the clinical units yields remarkable improvements in the distances traveled by patients.
本文提出一种方法，以帮助设计师分析复杂的护理流程，并同时考虑多个目标来确定急诊科（ED）的最佳布局。这些目标包括最小化患者的行程距离、最大化设计偏好以及最小化重新安置成本。
对医疗服务需求的不断增加导致对新医院建筑以及对现有医院进行翻新的需求也日益增长。运营管理技术已成功应用于制造业和服务业，以设计更高效的布局。然而，医疗流程的高度复杂性使得在医疗环境中应用这些技术具有挑战性。
应用流程挖掘技术来解决复杂性问题并加强医疗流程分析。从急诊科的信息系统中提取与流程相关的信息，如有关临床路径的信息。然后采用目标规划方法来找到一个能同时满足多个目标的单一布局。
使用所提出的方法确定的布局分别将非危急和危急患者的行程距离缩短了42.2%和47.6%，并使重新安置成本降至最低。
本研究表明，临床单元的高效布局可显著缩短患者的行程距离。
