Modeling & Optimization of Emergency Department(ED): A Case in Tikur Anbessa Specialized Hospital (TASH)
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Date
2019-10
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Addis Ababa University
Abstract
Healthcare Emergency Department modeling and optimization analysis is one of the tools that have
been applied to model and analyze the resource scheduling and performance of a healthcare system.
The modeling can be done either by analytical or simulation methods. The major problems of Tikur
Anbessa Specialized Hospital, Emergency Department is overcrowding related with high length of
stay, low throughput, high waiting time, low resource utilization, etc. Therefore, the principal
objectives of this thesis are to identify the scheduling parameters (key constraints) that affect the
allocation and scheduling of activities; to identify the critical sub activities contributing to lag overall
process and to make a flexible and optimal resource scheduling through modeling. Some papers done
in relation to health care and manufacturing system modeling has been reviewed for this thesis. Patient
records, processing time, etc. primary and secondary data have been collected from the case company,
through direct observation of the process and using stopwatch. Then, the data was analyzed and an
appropriate model was selected from the available fit of probabilistic distribution. Modeling of the ED
process was made with the help of (i.e. Arena™ student version) simulation and modeling software.
The model was verified and validated in order to ensure that it behaves the same as the real system and
finally analysis of the simulation model was conducted. Based on the analysis the optimized model
has been proposed for implementation. In this thesis, waiting time, length of stay, resource scheduling
optimization and flexibility, was used as a measure of the performance of the production line. After
analyzing the ED process model, a number of problems were identified including; longer queuing
time, absence of flexible flow lines and lower utilization of resources. Finally, a new model was
proposed where the length of stay has decreased by 25.6%, 16.23%, and 27.55% in first triage, front
assessment and red/resuscitation processes respectively. This reduction in length of stay increased the
throughput and reduced the overcrowding of the ED by more than ten percent. The achieved results in
the proposed model can be easily adapted after similar studies and the EDs can be improved
significantly.
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Keywords
Arena™, simulation, patient, length of stay, modeling, Emergency Department, resource