Bloomberg School of Public Health, Department of Health, Behavior and Society, Johns Hopkins University, Baltimore, MD.
Department of Operations, Business Analytics & Information Systems, Carl H. Lindner College of Business, University of Cincinnati, Cincinnati, OH.
Acad Emerg Med. 2018 Feb;25(2):238-249. doi: 10.1111/acem.13314. Epub 2017 Nov 11.
Computer simulation is a highly advantageous method for understanding and improving health care operations with a wide variety of possible applications. Most computer simulation studies in emergency medicine have sought to improve allocation of resources to meet demand or to assess the impact of hospital and other system policies on emergency department (ED) throughput. These models have enabled essential discoveries that can be used to improve the general structure and functioning of EDs. Theoretically, computer simulation could also be used to examine the impact of adding or modifying specific provider tasks. Doing so involves a number of unique considerations, particularly in the complex environment of acute care settings. In this paper, we describe conceptual advances and lessons learned during the design, parameterization, and validation of a computer simulation model constructed to evaluate changes in ED provider activity. We illustrate these concepts using examples from a study focused on the operational effects of HIV screening implementation in the ED. Presentation of our experience should emphasize the potential for application of computer simulation to study changes in health care provider activity and facilitate the progress of future investigators in this field.
计算机模拟是一种非常有利的方法，可以理解和改进医疗保健操作，具有广泛的可能应用。大多数急诊医学中的计算机模拟研究都试图改善资源分配以满足需求，或评估医院和其他系统政策对急诊部门（ED）吞吐量的影响。这些模型使能够进行基本的发现，这些发现可用于改善 ED 的总体结构和功能。从理论上讲，计算机模拟也可以用于检查添加或修改特定提供者任务的影响。这样做涉及许多独特的考虑因素，特别是在急性护理环境的复杂环境中。在本文中，我们描述了在设计、参数化和验证构建的计算机模拟模型以评估 ED 提供者活动变化时的概念性进展和经验教训。我们使用专注于 ED 中 HIV 筛查实施的操作效果的研究中的示例来说明这些概念。介绍我们的经验应强调计算机模拟在研究医疗保健提供者活动变化中的应用潜力，并为该领域的未来研究人员提供便利。
