Improving Emergency Department Processes Using Coloured Petri Nets

With increasing demand for medical services, emergency departments (ED) are facing problems such as overcrowding and dissatisfaction. Improving the key performance indicators of EDs has been the focal point of healthcare management. This paper addresses performance analysis of ED of a general hospital. To this aim, a discrete event dynamic modeling approach is used to model the ED processes. The model employs a hierarchical timed Coloured Petri net framework in a concise and detailed way to capture patient flow and care processes within the ED. The simulation model was validated against historical data and then different types of scenarios were used to assess, compare and improve ED key performance indicators, such as patients waiting time, length of stay (LOS), and resource utilization rate. The proposed model helped the hospital policy makers to configure the ED in a way to improve its efficiency and staff satisfaction.

[1]  Eui H. Park,et al.  Forecast Driven Simulation Model for Service Quality Improvement of the Emergency Department in the Moses H. Cone Memorial Hospital , 2008 .

[2]  O. Soremekun,et al.  Framework for analyzing wait times and other factors that impact patient satisfaction in the emergency department. , 2011, The Journal of emergency medicine.

[3]  R. Puri,et al.  Clinic , 1907, The American journal of dental science.

[4]  M. Dotoli,et al.  Modeling and management of a hospital department via Petri nets , 2010, 2010 IEEE Workshop on Health Care Management (WHCM).

[5]  D. Eitel,et al.  Improving service quality by understanding emergency department flow: a White Paper and position statement prepared for the American Academy of Emergency Medicine. , 2010, The Journal of emergency medicine.

[6]  van der Wmp Wil Aalst,et al.  From task descriptions via coloured Petri Nets towards an implementation of a new electronic patient record , 2006 .

[7]  Dominik Aronsky,et al.  Forecasting emergency department crowding: a discrete event simulation. , 2008, Annals of emergency medicine.

[8]  Ray J. Paul,et al.  Simulation in healthcare management: a soft approach (MAPIU) , 2004, Simul. Model. Pract. Theory.

[9]  MengChu Zhou,et al.  Modeling and performance analysis of medical services systems using Petri nets , 1994, Proceedings of IEEE International Conference on Systems, Man and Cybernetics.

[10]  Taesik Lee,et al.  Reducing Emergency Department overcrowding - five patient buffer concepts in comparison , 2008, 2008 Winter Simulation Conference.

[11]  Wil M. P. van der Aalst,et al.  Process Mining Techniques: an Application to Stroke Care , 2008, MIE.

[12]  J. Killeen,et al.  Impact of an express admit unit on emergency department length of stay. , 2010, The Journal of emergency medicine.

[13]  Mark A. Lawley,et al.  A stochastic control approach to avoiding Emergency Department overcrowding , 2010, Proceedings of the 2010 Winter Simulation Conference.

[14]  Lars Michael Kristensen,et al.  Coloured Petri Nets - Modelling and Validation of Concurrent Systems , 2009 .

[15]  W C A Pereira,et al.  Discrete-event computer simulation methods in the optimisation of a physiotherapy clinic. , 2011, Physiotherapy.

[16]  Prasad Nagula.  Redesigning the patient care delivery processes at an emergency department , 2006 .

[17]  Jingshan Li,et al.  A simulation study to improve quality of care in the emergency department of a community hospital. , 2012, Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association.

[18]  M. Khadem,et al.  Evaluating the layout of the emergency department of a public hospital using computer simulation modeling: A case study , 2008, 2008 IEEE International Conference on Industrial Engineering and Engineering Management.

[19]  Carlos J. González,et al.  Improving the quality of service in an emergency room using simulation-animation and total quality management , 1997 .

[20]  M.A. Centeno,et al.  Enhancing simulation models for emergency rooms using VBA , 1999, WSC'99. 1999 Winter Simulation Conference Proceedings. 'Simulation - A Bridge to the Future' (Cat. No.99CH37038).

[21]  Richard J Holden,et al.  Lean Thinking in emergency departments: a critical review. , 2011, Annals of emergency medicine.

[22]  Kurt Jensen.  An Introduction to the Practical Use of Coloured Petri Nets , 1996, Petri Nets.