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dc.creatorCildoz Esquíroz, Martaes_ES
dc.creatorIbarra, Amaiaes_ES
dc.creatorMallor Giménez, Fermínes_ES
dc.date.accessioned2020-04-24T09:11:18Z
dc.date.available2020-04-24T09:11:18Z
dc.date.issued2019
dc.identifier.issn2211-6923
dc.identifier.urihttps://hdl.handle.net/2454/36789
dc.description.abstractImproving the quality of healthcare in emergency departments (EDs) is at the forefront of many hospital managers’ efforts, as they strive to plan and implement better patient flow strategies. In this paper, a new approach to manage the patient flow in EDs after triage is proposed. The new queue discipline, named accumulative priority queue with finite horizon and denoted by APQ-h, is an extension of the accumulative priority queue (APQ) discipline that considers not only the acuity level of patients and their waiting time but also the stage of the healthcare treatment. APQ disciplines have been studied in the literature from a queueing theory point of view, which requires assumptions rarely found in real EDs, such as homogeneity in the patient arrival pattern and only one service stage. The APQ-h discipline accumulates priority from the point of waiting for the first physician consultation until the moment the waiting time exceeds the upper time limit set to access the physician after the patient's arrival. A recent study shows that a management strategy of this type is applied in practice in several Canadian EDs. The main aim of this paper is to explore the implementation of APQ-h managing policies in a real ED. For this purpose, a simulation model replicating a real ED is developed. This simulation model is also used to obtain the optimal APQ type polices through a simulation-based optimization method that solves a multi-objective and stochastic optimization problem. Arrival to provider time and total waiting time in the ED are considered to be the key ED performance indicators. An extensive computational analysis shows the flexibility of the APQ-h and APQ discipline and their superiority over other pure priority disciplines in a real setting and in a variety of ED scenarios. In addition, no superiority over the APQ discipline is demonstrated. © 2019 The Authorsen
dc.description.sponsorshipThis work was supported under grant MTM2016-77015-R (AEI, FEDER EU ).en
dc.format.extent19 p.
dc.format.mimetypeapplication/pdfen
dc.language.isoengen
dc.publisherElsevieren
dc.relation.ispartofOperations Research For Health Care, 23 (2019) 100224en
dc.rights© 2019 The Authors. This is an open access article under the CC BY-NC-ND license.en
dc.rights.urihttp://creativecommons.org/licenses/bync-nd/4.0/
dc.subjectAccumulative priority queuesen
dc.subjectEmergency departmenten
dc.subjectPatient flowen
dc.subjectQueue disciplineen
dc.subjectSimulation-based optimizationen
dc.titleAccumulating priority queues versus pure priority queues for managing patients in emergency departmentsen
dc.typeinfo:eu-repo/semantics/articleen
dc.typeArtículo / Artikuluaes
dc.contributor.departmentInstitute of Smart Cities - ISCes_ES
dc.rights.accessRightsinfo:eu-repo/semantics/openAccessen
dc.rights.accessRightsAcceso abierto / Sarbide irekiaes
dc.identifier.doi10.1016/j.orhc.2019.100224
dc.relation.projectIDinfo:eu-repo/grantAgreement/ES/1PE/MTM2016-77015-Ren
dc.relation.publisherversionhttps://doi.org/10.1016/j.orhc.2019.100224
dc.type.versioninfo:eu-repo/semantics/publishedVersionen
dc.type.versionVersión publicada / Argitaratu den bertsioaes


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© 2019 The Authors. This is an open access article under the CC BY-NC-ND license.
La licencia del ítem se describe como © 2019 The Authors. This is an open access article under the CC BY-NC-ND license.

El Repositorio ha recibido la ayuda de la Fundación Española para la Ciencia y la Tecnología para la realización de actividades en el ámbito del fomento de la investigación científica de excelencia, en la Línea 2. Repositorios institucionales (convocatoria 2020-2021).
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