Background
Data and methods
Patient flow in the surgical ED and simulation model
16:00–08:15 | 07:15–16:15 | 14:00–23:00 | |
---|---|---|---|
Monday–Friday | 1 Physician 3 Nurses | 3 Physicians 4 Nurses | 1 Physician 3 Nurses |
Saturday, Sunday | 1 Physician 3 Nurses | 2 Physicians 4 Nurses | 1 Physician 4 Nurses |
Triage category | Immediate | Very urgent | Urgent | Standard | Non-urgent |
---|---|---|---|---|---|
Percentage | 0.36 | 5.91 | 26.91 | 53.91 | 12.91 |
Maximum waiting time (min) | 0 | 10 | 30 | 90 | 120 |
Data collection
Patient arrival
Process activities
Process activity | Triage | Physical examination | Handing over patient (nurse to physician) | Physical examination and interviewing | X-ray | CT scan | Blood testing | Analysis of X-ray | Analysis of CT | Treatment (injection/cast/bandage etc.) | First documentation (of anamnesis and results) | Final documentation (completion of discharge letter) | Trauma room (urgent emergency) |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Resource | Triage nurse | Nurse | Nurse, physician | Physician | X-ray department | X-ray department | Laboratory | Physician | Physician | Physician | Physician | Physician | Nurse, physician |
Data source | TMS | TMS | TMS | TMS | CIS | CIS | CIS | TMS | TMS | TMS | TMS | TMS | TMS |
Mean (time in min) | 5.08 | 4.06 | 1.46 | 4.55 | 18.66 | 46.05 | 34.08 | 2.61 | 2.85 | 11.91 | 6.88 | 7.9 | 39.05 |
Standard deviation (in min) | 3.73 | 3.09 | 1.58 | 2.85 | 16.67 | 32.05 | – | 2.31 | 1.76 | 11.21 | 5.3 | 5.47 | 13.08 |
Results
Improvement of documentation efficiency/number of documentation assistants (%) | 0 | 1 | 2 | 3 | 4 | 5 | 6 |
---|---|---|---|---|---|---|---|
0 | 0.95586138 | 0.90851259 | 0.85600901 | 0.82543679 | 0.81478161 | 0.8216141 | 0.81484681 |
5 | 0.95116114 | 0.90154917 | 0.84816247 | 0.81656295 | 0.80537848 | 0.80877604 | 0.8058309 |
10 | 0.95644712 | 0.89779539 | 0.83217917 | 0.81203976 | 0.80236947 | 0.79904161 | 0.7951842 |
15 | 0.95450305 | 0.89039862 | 0.82852664 | 0.7962661 | 0.79050967 |
0.78706467
|
0.78376729
|
20 | 0.95310867 | 0.8877983 | 0.81547893 |
0.78853803
|
0.77847204
|
0.77588683
|
0.77737212
|
25 | 0.95508084 | 0.87670289 | 0.80305884 |
0.77843705
|
0.77023271
|
0.76783064
|
0.76252425
|
30 | 0.95138378 | 0.87609568 | 0.79106149 |
0.76401855
|
0.75805195
|
0.74755924
|
0.75663769
|
35 | 0.95539147 | 0.86085714 |
0.78118526
|
0.75060058
|
0.74887092
|
0.74933448
|
0.75064856
|
40 | 0.9563154 | 0.84815266 |
0.7646406
|
0.73999072
|
0.73382242
|
0.73223801
|
0.73101034
|
45 | 0.95517466 | 0.84099205 |
0.74957196
|
0.72704585
|
0.72341399
|
0.72533766
|
0.72312589
|
50 | 0.956392 | 0.82909488 |
0.74157911
|
0.71411821
|
0.71506467
|
0.71098648
|
0.71082958
|