ORAHS 2014 edition:40 location:Lisbon (Portugal) date:20-25 July 2014
Emergency department (ED) crowding is a major problem in healthcare institutions all over the world. A key issue affecting this problem, is inpatient boarding or inpatient access block. If inpatient units are heavily loaded, emergency patients that should be admitted may be blocked in the emergency department. These blocked patients occupy valuable emergency department space, time and resources and thus aggravate crowding. This poster presents the results of a detailed simulation study carried out at the ED of a large regional hospital in Belgium, where hospital management considers introducing buffer beds , located outside the emergency department, for patients that are waiting to be admitted. Although it is known that the inpatient units are a major factor influencing emergency department overcrowding, they are rarely considered in analyses of emergency departments. The most important contribution of this case study is that it indirectly takes the impact of the inpatient units into account, by analyzing the times that patients currently remain "blocked" in the ED department, and studying the mitigating impact of buffer beds on this blocking effect. It thus allows hospital management to determine how many beds are necessary to avoid blocking in the emergency department. Furthermore, we analyze to which extent the combined effect of staff schedule changes and number of buffer beds can influence the length-of-stay of patients in the ED. The simulation model is built upon highly detailed data regarding patient mix, patient routings, and patient processing requirements with respect to different ED resources (doctors, nurses, boxes/beds).