Abstract
BackgroundMany hospitals in China experience large volumes of emergency department (ED) radiology patients, thereby lengthening the wait times for non-emergency radiology patients. We examine whether an emergency reservation policy which deals with stochastic arrivals of ED patients can shorten wait times, and what effect it has on patient and hospital related metrics.MethodsIn this study, operations research models are used to develop an emergency reservation policy. First, we construct a discrete event simulation (DES) model based on the process of patients served by one computed tomography (CT) scanner at West China Hospital (WCH). Next, a newsvendor model is built to compute the daily reservation quantity for emergency patients. Based on the appointment scheduling rule and daily emergency reservation policies, the effects of the proposed policy on daily examination quantity, patient wait times, and equipment utilization are explicitly modeled. Finally, we evaluate the impact of different reservation policies on these system performance measures.ResultsOur analysis indicates that reserving capacity for emergency patients greatly shortens the delay for non-emergency patients with an average 43.9% reduction in total wait times. The pre-model utilization and average post-model utilization are 99.3% and 98.5%, respectively. In addition, the comparison of different reservation policies shows that there is no significant difference between any two policies in terms of patients’ wait times.ConclusionsReserving proper capacity for emergency patients not only positively affects the patients’ delay times, but also affects various aspects of the hospital. Our goal is to design a simple and implementable emergency reservation policy. DES proves to be an effective tool for studying the effects of proposed scenarios to optimize capacity allocation in radiology management.
Highlights
IntroductionWe examine whether an emergency reservation policy which deals with stochastic arrivals of emergency department (ED) patients can shorten wait times, and what effect it has on patient and hospital related metrics
Many hospitals in China experience large volumes of emergency department (ED) radiology patients, thereby lengthening the wait times for non-emergency radiology patients
Emergency patients frequency element a in the scheduling rule refers to the appointment time interval, the second element n refers to the number of patients making appointments during the appointment time interval a, and the third element n1 refers to the number of patients making appointments at the beginning
Summary
We examine whether an emergency reservation policy which deals with stochastic arrivals of ED patients can shorten wait times, and what effect it has on patient and hospital related metrics. Medical imaging equipment, such as computed tomography (CT) scanner, constitutes a critical component of a comprehensive health care system and plays a key role in the diagnosis and treatment of disease [1]. The problem faced by the radiology department is that there is no scientific method to determine how much capacity should be reserved for emergency patients. The above analysis highlights the need for operations research models that provide a scientific emergency reservation policy for hospital managers
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