Redesign of the University of Virginia’s Emergency Department Waiting Room Layout to Optimize Patient Flow and Increase Satisfaction; Efficiency at What Cost? Human-Centered Consequences of Metric-Driven Systems in Healthcare and Beyond

The relationship between my technical project and my STS research paper revolves around improving the emergency department operations. My technical project, "Redesign of the University of Virginia’s Emergency Department Waiting Room Layout to Optimize Patient Flow and Increase Satisfaction," used simulation modeling to simulate a newly designed waiting room for UVA’s emergency department. While this paper focuses on physical improvements that can be done to UVA’s emergency department, my STS paper focuses on the impact of an overemphasis on efficiency, in American culture but mainly on healthcare. Together, they discuss the importance of balancing technical innovation with sociotechnical awareness in engineering practice and healthcare. In my STS research, I looked into the dangers of America’s cultural obsession with speed, productivity, and efficiency at the expense of quality and human-centered outcomes. The paper looked into case studies ranging from Amazon warehouse labor practices to the U.S. government’s newly implemented Department of Government Efficiency, and most importantly, UVA Health’s Provider in Triage (PIT); highlighting how a narrow focus on metrics can become a distraction from real-world problems. I discussed UVA Health’s success at lowering its “left without being seen” (LWBS) rate after implementing a PIT model. However through interviews with staff, they discussed how although their LWBS rate had been lowered the actual patient’s satisfaction and quality of care was less clear. Outside of healthcare, I researched and compared America and Japan’s auto industry. While America had a large focus on efficiency at all costs, Japan prioritized quality through principles like “jidoka” (automation with a human touch) and "kaizen" (continuous improvement). My research argued that while metrics are valuable, they must be interpreted alongside human experience and ethical reflection. My technical project produced a simulation of a redesigned waiting room of the UVA emergency department. Using the simulation software FlexSim HC, over 60 hours of emergency department observations, and the help of the hospital staff, my team proposed a new waiting room layout that introduced "progression areas" that reduce patient congestion and create a perception of forward movement through care. While the redesigned model remained similar to the former, its variance decreased by 83%. This reduction in variance means patients will experience a more predictable wait time, making their experience less stressful and increasing satisfaction. The updated waiting room design also had a slight increase in average triage time by 2%, however trauma patients movements increased by 30%. The majority of patients are stable, and thus it will be okay to travel a bit more, but the most pressing and non-stable patients will benefit from less travel time. Performing both projects taught me that technical improvements must be paired with qualitative human insights. Metrics like wait times and LWBS rates, while important, cannot capture the full patient experience.