Yale School of Medicine (Kim), and Department of Psychiatry and Department of Emergency Medicine (Chepenik), Yale School of Medicine, New Haven, Connecticut. Marcela Horvitz-Lennon, M.D., and Kenneth Minkoff, M.D., are editors of this column.
Psychiatr Serv. 2020 Jan 1;71(1):92-95. doi: 10.1176/appi.ps.201900040. Epub 2019 Oct 8.
Computer simulation using JaamSim tested the impact of changing the number of providers, proportion of independent to supervised providers, shift provider added, time to hospitalization, and the number of beds in order to identify bottlenecks in a psychiatric emergency department. Adding an independent provider from 4 p.m. to midnight produced the largest improvements: reductions in time to bed, time to provider, and length of stay by 82%, 68%, and 31%, respectively. Decreasing time to hospitalization and adding beds achieved modest improvements. Modeling allows simulated changes to one parameter at a time and provides bespoke analysis for a variety of clinical settings.
使用 JaamSim 的计算机模拟测试了改变提供者数量、独立提供者与监督提供者的比例、增加班次提供者、住院时间以及床位数量,以确定精神科急诊部门的瓶颈。从下午 4 点到午夜增加一名独立提供者产生了最大的改善:分别减少了 82%、68%和 31%的床位等待时间、提供者等待时间和住院时间。减少住院时间和增加床位可以取得适度的改善。建模允许一次模拟改变一个参数,并为各种临床环境提供定制分析。