A discrete-event simulation study for emergency room capacity management in a Hong Kong hospital

Abstract

It is very common for patients to face a long journey after the first physician visit in many emergency service care models. This affects the service quality of accident and emergency departments (AEDs). In this study, we developed discrete-event simulation models to mimic the complex health service system of a 24-hour AED in Hong Kong. We assessed how changing the number of emergency department physicians or the patient journey influenced AED performance achievement, which was quantified as service achievements for patients (SAP). We observed that reducing the time spent on subsequent treatments (after the first physician visit) among semi-urgent patients was comparatively sensitive to improving the overall AED outcomes. There was an increase in mean service achievements from 69.29% to 79.30% (95% confidence intervals were 1.28% and 0.98%, respectively). The proposed model is helpful in making decisions about emergency resource planning when there is a sudden surge of emergency patients.