Fourth International Conference on Health Care Systems Engineering

Montreal, 30 May — 1 June 2019

Schedule Authors My Schedule

Emergency services

May 30, 2019 01:00 PM – 02:30 PM

Location: Room: Marcel Lacoste

3 Presentations

  • 01:00 PM - 01:30 PM

    Coxian phase-type regression models for understanding the relationship between patient attributes, overcrowding, and length of stay in hospital emergency departments

    • Laura Boyle, presenter, Queen's University Belfast
    • Adele Marshall, Queen's University Belfast
    • Mark Mackay, University of South Australia

    Hospital emergency departments operate under significant pressure worldwide. Overcrowding is a frequent occurrence, caused by a combination of high presentation numbers, and long delays in the admission of patients due to a lack of availability of hospital beds. Understanding the factors which influence length of stay (LoS) in the emergency department (ED) is a vital aspect of any strategy to improve patient flow and increase system performance. The determinants of ED patient flow are complex and varied, due to the diverse population of patients competing for limited resources. This research uses Coxian phase-type distributions to cluster patients into groups by their length of stay, using a unique diagram for improved communication of patient flow issues. A novel application of survival analysis is presented to simultaneously evaluate the effect of patient attributes, system factors, and overcrowding on emergency department length of stay. The approach is demonstrated with application to emergency department data Flinders Medical Centre in South Australia.

  • 01:30 PM - 02:00 PM

    A two-phase approach to the Emergency Department Physician Rostering Problem

    • Paola Cappanera, DINFO, University of Florence, Italy
    • Filippo Visintin, presenter, University of Florence
    • Roberta Rossi, University of Florence

    In this study, we address the physician rostering problem occurring in an Emergency Department of an Italian paediatric hospital. Motivated by the paramount importance that workload balance has in this setting, we propose a tailored two-phase approach and we present two optimization models on which the proposed approach is based.
    In the first phase, we assign all the weekend (and holidays) shifts to physicians in a medium-term planning horizon pursuing a fair distribution of weekend and night shifts among the physicians, whereas in the second phase, we assign all the weekday shifts to physicians in short-term planning horizons so that each physician works almost the same number of morning and afternoon shifts. We present preliminary results of an ongoing research whose ultimate goal is to develop a decision support system to facilitate the creation of physicians' rosters.

  • 02:00 PM - 02:30 PM

    Facing Implementation barriers to simulation studies

    • Clio Dosi, presenter, University of Modena and Reggio Emilia
    • Manuel Iori, Università degli Studi di Modena e Reggio Emilia
    • Arthur Kramer, University of Modena and Reggio Emilia
    • Matteo Vignoli, University of Modena and Reggio Emilia

    Implementation barriers to simulation studies are a reality in today's’ organizations. This work proposes a novel model to use simulation to maximise successful implementation by 1) ​framing the right problem to face; 2) using what-if scenarios as an exploration tool for users’ value; 3) supporting knowledge integration in giving tangible results to discuss among different professionals. We successfully tested the model in a 18 months Emergency Department overcrowding case study.