Steward Duane, Glass Todd F, Ferrand Yann B
Biomedical Informatics, College of Medicine, Texas A&M Health Science Center, Bryan, TX, 77807, USA.
Department of Management, Clemson University, Clemson, SC, 29634, USA.
J Med Syst. 2017 Sep 6;41(10):162. doi: 10.1007/s10916-017-0804-6.
Faced with the opportunity to significantly deviate from classic operations, a new emergency department (ED) and novel strategy for patient care delivery were simultaneously initiated with the aid of model-based simulation. To answer the design and implementation questions, a traditional strategy for construction of discrete-eventmodel simulation was employed to define ED operations for a newly constructed facility in terms of workflow, variables, resources, structure, process logic and associated assumptions. Benefits were achieved before, during and after implementation of an unprecedented operations strategy-i.e., the organization of the ED care delivery around four care streams: Critical, Diagnostic, Therapeutic and Fast Track. Prior to opening, it shed light on the range of context variables where benefits might be anticipated, and it facilitated staff understanding and judgements of performance. Two years after opening, the operations data is compared to the simulation with encouraging results that shed light on where to continue pursuit of improvement.
面对显著偏离传统操作的机会，在基于模型的模拟辅助下，一个新的急诊科和一种全新的患者护理提供策略同时启动。为了回答设计和实施问题，采用了传统的离散事件模型模拟构建策略，从工作流程、变量、资源、结构、流程逻辑和相关假设等方面定义新建设施的急诊科操作。在实施一项前所未有的操作策略期间及之后都取得了成效，该策略即围绕四个护理流程组织急诊科护理服务：危急、诊断、治疗和快速通道。开业前，它揭示了可能预期会有成效的背景变量范围，并促进了工作人员对绩效的理解和判断。开业两年后，将运营数据与模拟结果进行比较，结果令人鼓舞，揭示了继续追求改进的方向。
