What is the average time patients spend in the ed

Reference no: EM133705825

Assignment:

Hospital Emergency Department Management wants to study the operations of the Emergency Department (ED) at a city hospital with an eventual goal of improving patient flow and reducing wait times. The first step is to model the ED as it currently operates. The ED is open 24 hours a day. Patients arrive at the ED individually, with interarrival times distributed exponentially with a mean of 5 minutes. Upon arrival, 50% of the patients go to the triage nurse for an assessment, 40% use an automated check-in kiosk to describe their symptoms, and the remaining 10% are direct admissions (ambulance arrivals) and bypass the initial check-in process, proceeding directly to the waiting area for medical examination.

Direct admissions take between 1 and 2 minutes, uniformly distributed, from their arrival to being ready for medical examination. The other two patient types (walk-ins) move instantly from their arrival to the triage nurse or automated check-in kiosk as the case may be. There are two identical triage nurses at the check-in desk. Triage assessment times follow a triangular distribution between 3 and 7 minutes with a mode of 5 minutes.

After triage, patients move to the waiting area before being seen by a medical staff. The automated check-in kiosk includes a questionnaire tailored to identify the patient's symptoms and urgency. The check-in time at the kiosk is triangularly distributed between 1 and 4 minutes with a mode of 2.5 minutes. The automated check-in kiosk requires maintenance after every 100 to 150 uses (uniformly distributed). Once a kiosk requires maintenance, it takes 10 minutes (constant) to service and return it to operation. After using the kiosk, patients proceed to the waiting area before being seen by a medical staff.

All patients eventually reach the medical examination phase, where there are several identical medical staff available, with the number of medical staff varying throughout the day. There are 10 medical staff members available between 8 am and 4 pm (the first 8 hours of the day), 8 medical staff members available between 4 pm and midnight (the second 8 hours of the day), and 6 medical staff members available between midnight and 8 am (the last 8 hours of the day). Direct admissions (ambulance arrivals) have a higher priority than the other types of patients (walk-ins). Medical examination times for all patients are exponentially distributed with a mean of 30 minutes. This distribution captures all the possibilities there, like medical history review, physical examination, diagnostic tests, etc. Once through the medical examination, patients either are admitted to the hospital, discharged, or referred to specialists, and are no longer in our model.

Simulate this system in Arena for 100 hours and answer the following questions.

1. What is the average time patients spend in the ED (i.e., total time in the system)?

2. What was the maximum time someone spent in the ED in your simulation?

3. What is the average time direct admission patients have to wait before being seen by a medical staff?

4. What is the average time other types of patients (walk-ins) have to wait before being seen by a medical staff?

5. What is the average utilization of the check-in nurses, check-in kiosk, and medical staff?

6. In what percent of the times the check-in kiosk is in busy, idle, and failed state?

Reference no: EM133705825

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