Enhancement of Intra-hospital patient transfer in medical center hospital using discrete event system simulation

The intra-hospital transfer of critically ill patients are associated with complications at up to 70%. Numerous issues can be avoided with optimal pre-transport planning and communication. Simulation models have been demonstrated to be an effective method for modeling processes and enhancing on-time...

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Bibliographic Details
Published in:	PloS one 2023-04, Vol.18 (4), p.e0282592-e0282592
Main Authors:	Meephu, Ekkarat, Arwatchananukul, Sujitra, Aunsri, Nattapol
Format:	Article
Language:	eng
Subjects:	Biology and Life Sciences Care and treatment Complications Computer and Information Sciences Computer Simulation Departments Design of experiments Discrete event systems Efficiency Efficiency, Organizational Emergency medical care Emergency Service, Hospital Engineering and Technology Evaluation Health care facilities Health facilities Hospitals Hospitals, General Humans Intensive care Management systems Medical care Medical research Medicine and Health Sciences Modelling Outpatient care facilities Patient Transfer Patients Physical sciences Physiology Quality management Queues Research and Analysis Methods Simulation Simulation models Software Stretchers System effectiveness Time Factors Transportation planning Wheelchairs Workforce planning
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Summary:	The intra-hospital transfer of critically ill patients are associated with complications at up to 70%. Numerous issues can be avoided with optimal pre-transport planning and communication. Simulation models have been demonstrated to be an effective method for modeling processes and enhancing on-time service and queue management. Discrete-event simulation (DES) models are acceptable for general hospital systems with increased variability. Herein, they are used to improve service effectiveness. A prospective observational study was conducted on 13 official day patient transfers, resulting in a total of 827 active patient transfers. Patient flow was simulated using discrete-event simulation (DES) to accurately and precisely represent real-world systems and act accordingly. Several patient transfer criteria were examined to create a more realistic simulation of patient flow. Waiting times were also measured to assess the efficiency of the patient transfer process. A simulation was conducted to identify 20 scenarios in order to discover the optimal scenario in which where the number of requests (stretchers or wheelchairs) was increased, while the number of staff was decreased to determine mean waiting times and confidence intervals. The most effective approach for decreasing waiting times involved prioritizing patients with the most severe symptoms. After a transfer process was completed, staff attended to the next transfer process without returning to base. Results show that the average waiting time was reduced by 21.78% which is significantly important for emergency cases. A significant difference was recorded between typical and recommended patient transfer processes when the number of requests increased. To decrease waiting times, the patient transfer procedure should be modified according to our proposed DES model, which can be used to analyze and design queue management systems that achieve optimal waiting times.
ISSN:	1932-6203 1932-6203