Desarrollo e implementación de un modelo de simulación para la mejora del Servicio de Urgencias

Abstract

Since the new Emergency Department of the Hospital of Navarre was built (which has 3.500 square meters of facilities that serve a population of half a million people), it emerged the need to enhance the system performance by shortening the length of stay, improving patient satisfaction and reducing physicians’ work overload. As part of a larger project, it is studied how to avoid disparities between physicians in the mild patients’ circuit (A). At the present time, patients in triage are assigned to physicians cyclically as they arrive to the Emergency Department which facilitates the triage nurses decision making although it leads to an imbalanced workload of the physicians. Our approach consider the development of a discrete-event simulation model that takes into account an accurate description of patient flow, medical and nurse procedures, and characteristics of patient (health status, seasonal patterns of arrivals, etc.). The model parameters calibration and estimation is based on a thorough analysis of real historical data associated to this new department (more than 120.000 patient cases during its first operating year). By using this mathematical model, we compare the actual patient-physicians assignment policy with other assignment rules proposed by the medical teams who work in the new Hospital of Navarre Emergency Department (and also by the author) with the aim of balancing physicians’ workload and reducing patients waiting time.