Saunders C E, Makens P K, Leblanc L J
Department of Emergency Medical Services, School of Medicine, University of California, San Francisco.
Ann Emerg Med. 1989 Feb;18(2):134-40. doi: 10.1016/s0196-0644(89)80101-5.
We developed a computer simulation model of emergency department operations using simulation software. This model uses multiple levels of preemptive patient priority; assigns each patient to an individual nurse and physician; incorporates all standard tests, procedures, and consultations; and allows patient service processes to proceed simultaneously, sequentially, repetitively, or a combination of these. Selected input data, including the number of physicians, nurses, and treatment beds, and the blood test turnaround time, then were varied systematically to determine their simulated effect on patient throughput time, selected queue sizes, and rates of resource utilization. Patient throughput time varied directly with laboratory service times and inversely with the number of physician or nurse servers. Resource utilization rates varied inversely with resource availability, and patient waiting time and patient throughput time varied indirectly with the level of patient acuity. The simulation can be animated on a computer monitor, showing simulated patients, specimens, and staff members moving throughout the ED. Computer simulation is a potentially useful tool that can help predict the results of changes in the ED system without actually altering it and may have implications for planning, optimizing resources, and improving the efficiency and quality of care.
我们使用模拟软件开发了一个急诊科运营的计算机模拟模型。该模型采用多级优先患者优先级；为每位患者分配一名护士和一名医生；纳入所有标准检查、程序和会诊；并允许患者服务流程同时、顺序、重复进行或这些方式的组合。然后，系统地改变选定的输入数据，包括医生、护士和治疗床的数量以及血液检测周转时间，以确定它们对患者周转时间、选定队列大小和资源利用率的模拟影响。患者周转时间与实验室服务时间成正比，与医生或护士服务人员数量成反比。资源利用率与资源可用性成反比，患者等待时间和患者周转时间与患者 acuity 水平间接相关。该模拟可以在计算机显示器上进行动画演示，显示模拟患者、标本和工作人员在急诊科各处的移动。计算机模拟是一种潜在有用的工具，可以帮助预测急诊科系统变化的结果而无需实际改变它，并且可能对规划、优化资源以及提高护理效率和质量产生影响。
