Analysis of Patient Flow Using Discrete Event Simulation for An Emergency Room: A Case Study of Bhim Hospital Rupandehi, Nepal
Date
2024-06
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Pulchowk Campus
Abstract
The Emergency Room experiences a daily influx of patients, putting significant strain
on departmental resources. Concurrently, treatment duration for patients has risen,
leading to dissatisfaction and prolonged wait times. Hospital management is exerting
maximum effort within existing resources to mitigate these issues, with a primary
focus on reducing wait times. To address these challenges, a Discrete Event
Simulation is employed to simulate real-world scenarios and identify optimal
solutions for reducing length of stay, wait times, and other contributing factors, thus
bolstering the foundation for robust decision-making. Bhim Hospital's Emergency
Room serves as the case study, assessing wait times, length of stay, and bed
utilization. Experimental scenarios are applied to the model, aiding the hospital
management team in decision-making processes. Selection and rejection of strategies
are based on paired test analyses, comparing real-world hospital data with results
generated by the simulation model. Given the feasibility of all scenarios in decreasing
length of stay, and bed occupancy rates, the results are recommended to the hospital
for implementation. The time to stay for Red zone, Green zone and Yellow zone patients
is 6 hours according to hospital data and simulation suggest of 3,4 and 5 hours
respectively, this also suggest on decreasing of length of stay in the hospital.
The percentage of RED BED occupy by Red zone patients in Base case is 16.64%,
whereas for REST BED is 10.06%. Similarly for alternative 2, slight reduction in bed for
both RED BED and REST BED of 10.21% and 6.724% respectively. Furthermore, by
adding one more Physician decreases bed utilization to 10.62% less then base case and
for REST BED to 7.39%. Finally, adding a path lab inside the Emergency room and only
one Physician increases the RED BEDS utilization, but decreases in REST BED
utilization by 17.097% and 9.467% respectively.
Description
The increasing concern for healthcare quality has made the healthcare industry
essential for people. With this rising concern, the time taken for check-ups has also
increased, highlighting the strain on healthcare resources such as human resources and
testing equipment (Fadhil, Jusop et al., 2012). Public healthcare institutions are facing
challenges due to long waiting times for services (Ghazali et al., 2011). Tehrani,
Feldman, Camacho, and Balkrishnan (2011) conducted a survey revealing that
waiting time significantly affects patient satisfaction. In Nepal, the government has
released the National Health Policy, emphasizing the optimal use of healthcare sector
resources within financial constraints to deliver high-quality healthcare services and
enhance the efficiency and effectiveness of the healthcare system
Keywords
Emergency Room, Physician