ArticleThe American journal of emergency medicine2014
Using discrete event computer simulation to improve patient flow in a Ghanaian acute care hospital.
Article in The American journal of emergency medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Methodological Approaches to Support Process Improvement in Emergency Departments: A Systematic Review.International journal of environmental research and public health · 2020Pooled it
- Comparison of patient flow and provider efficiency of two delivery strategies for HPV-based cervical cancer screening in Western Kenya: a time and motion study.Global health action · 2018Trial
- Simulation to optimize the laboratory diagnosis of bacteremia.Microbiology spectrum · 2024Article
- Planning for resilience in screening operations using discrete event simulation modeling: example of HPV testing in Peru.Implementation science communications · 2022Article
- Using discrete event simulation to optimize nucleic acid testing process for coronavirus disease 2019 (COVID-19).Journal of thoracic disease · 2022Article
- Article
- Variation in referral rates to emergency departments and inpatient services from a GP out of hours service and the potential impact of alternative staffing models.Emergency medicine journal : EMJ · 2021Article
- Integrating HIV, syphilis, malaria and anaemia point-of-care testing (POCT) for antenatal care at dispensaries in western Kenya: discrete-event simulation modelling of operational impact.BMC public health · 2019Article
- Understanding Emergency Care Delivery Through Computer Simulation Modeling.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2018Article
- A systematic literature review of simulation models for non-technical skill training in healthcare logistics.Advances in simulation (London, England) · 2018Article
- A preliminary study of a novel emergency department nursing triage simulation for research applications.BMC research notes · 2017Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesCrowding and limited resources have increased the strain on acute care facilities and emergency departments worldwide. These problems are particularly prevalent in developing countries. Discrete event simulation is a computer-based tool that can be used to estimate how changes to complex health care delivery systems such as emergency departments will affect operational performance. Using this modality, our objective was to identify operational interventions that could potentially improve patient throughput of one acute care setting in a developing country.
methodsWe developed a simulation model of acute care at a district level hospital in Ghana to test the effects of resource-neutral (eg, modified staff start times and roles) and resource-additional (eg, increased staff) operational interventions on patient throughput. Previously captured deidentified time-and-motion data from 487 acute care patients were used to develop and test the model. The primary outcome was the modeled effect of interventions on patient length of stay (LOS).
resultsThe base-case (no change) scenario had a mean LOS of 292 minutes (95% confidence interval [CI], 291-293). In isolation, adding staffing, changing staff roles, and varying shift times did not affect overall patient LOS. Specifically, adding 2 registration workers, history takers, and physicians resulted in a 23.8-minute (95% CI, 22.3-25.3) LOS decrease. However, when shift start times were coordinated with patient arrival patterns, potential mean LOS was decreased by 96 minutes (95% CI, 94-98), and with the simultaneous combination of staff roles (registration and history taking), there was an overall mean LOS reduction of 152 minutes (95% CI, 150-154).
conclusionsResource-neutral interventions identified through discrete event simulation modeling have the potential to improve acute care throughput in this Ghanaian municipal hospital. Discrete event simulation offers another approach to identifying potentially effective interventions to improve patient flow in emergency and acute care in resource-limited settings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.