Differentiated waiting time management according to patient class in an emergency care center using an open Jackson network integrated with pooling and prioritizing

Abstract

Unlike ordinary outpatient clinics, an emergency care center sees a variety of patients with diverse diseases and injuries of different levels of severity. Since patients who are in a critical condition face serious consequences, target waiting times must be determined based on patient acuity levels. To reflect the special situation in emergency care centers included in this study, patient flows are formulated using an open Jackson network with multiple patient classes. This paper is unique because of the integration of pooling and prioritizing patient classes with the open Jackson network. In particular, a hybrid priority model is presented in which a first-come-first-served discipline is applied in some processes and a priority discipline is applied in other processes in the open Jackson network, in order to minimize waiting times for patients with more urgent concerns. A case study based on actual data from an emergency care center demonstrates that the proposed model of pooling and prioritizing patient classes is effective in decreasing waiting times for higher-priority classes without substantially sacrificing those for lower-priority classes.