Evaluation of Alternative Functional Designs in an Emergency Department by Means of Simulation

We evaluate the efficiency of different functional structures, reorganization patterns and alternative allocation of eventual new resources in a hospital emergency department. This department was simulated as a queue system in a process approach with SIMSCRIPT II.5. The data adjustment to statistical distributions of probability was made with UNIFIT II. The network containing the intermediate service circuit of the patients, from their arrival to their leaving, was modelled through nine interconnected queue systems. Actual operations as well as eight different alternative scenarios were simulated and compared. Changes in human resources, arrival rates and service times of auxiliary diagnostics equipment were simulated. We conclude that the medical classifying service should not be potentiated at the expense of the second level (general emergency doctors). Monitoring arrival times is also suggested. Collapses and saturation levels would occur if the arrival time were 12 patients per hour, being now almost 11 at some fixed times of the day. Expenditure in additional human resources would be more efficient socially than investment in auxiliary services equipment (Laboratory or X-Ray).