Improving emergency departments: Simulation-based optimization of patients waiting time and staff allocation in an Iranian hospital

ABSTRACT

Emergency department (ED) is known as the beating heart of a hospital which operates 24 hours, every day of a year. It provides services to a wide spectrum of patients with various medical conditions. Therefore, it is crucial to simulate and optimize the ED’s processes for enhancement of services provided. Improving processes can be challenging, especially when a complex and unpredictable environment such as ED is under study. This research aims to identify an improved allocation of resources in different wards of an emergency department, with the goal of improving the patients and staff workflow. The research approach untaken is a case study at a state hospital in the Semnan province, Iran. The emergency department of this hospital is evaluated for a new layout design by which the average patients waiting time be reduced and the allocation of staff be optimized. The simulation technique, using Arena, is adopted to fulfil these goals. Recommendations are proposed for a layout design which could improve the average waiting time of the Internal-Emergent patients by 23.18% and the Surgical-Emergent patients by 81.7%. This means waiting time reduction of 3.31 minutes for the Internal-Emergent patients and 10.58 minutes for the Emergent patients.

KEYWORDS:

• Patient waiting time
• staff levelling and allocation
• process improvement
• emergency department (ED)
• hospital
• simulation

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Soori Sasanfar

Soori Sasanfar received her masters in industrial engineering from Iran university of science and technology.

Morteza Bagherpour

Dr. Morteza Bagherpour is a faculty member at Iran University of science and technology. He has published over 100 articles in international journals and conferences.

Afrooz Moatari-Kazerouni

Afrooz Moatari-Kazerouni is a faculty in the Dhillon School of Business at University of Lethbridge, AB, Canada. She received a doctoral degree in Industrial Engineering from Ecole Polytechnique de Montreal, Canada. She was a post-doctoral fellow at McGill University and at the Universite of Quebec in Montreal (UQAM), Canada. Her research interests focus upon supply chain and operations management, practicing in subject areas of: process improvements, technology management, facility layout design, and new product development modeling. She has worked on various consultancy projects within the service sector and collaborated with several healthcare settings in Canada and USA. She also has the experience of working with manufacturing industries in the field of telecommunication and aeronautics in Canada and Denmark.