Resource optimization and waiting time reduction of emergency department using discrete event simulation

PURPOSE: This study aims to propose a reliable tool for analyzing current ED operations, improving ED bottlenecks and optimizing resource allocation for improving ED service quality and strategically plan their resources to cater the present demands. METHODS: Discrete Event Simulation (DES) is used to build an ED model by using ARENA Software and its finding identifies the bottlenecks encountered. The variables employed in the model are specified by triage zones: red, yellow, and green. The Red Zone is responsible for treating critical cases, the Yellow Zone is treating semi-critical situations and the Green Zone is utilized to treat all non-critical cases. Four alternative improvements are proposed to resolve the bottlenecks. The proposed alternatives contain new configuration of department resources; doctors and nurses. Input and output values for each alternative are determined through the DES model. RESULTS: The existing ED system’s results suggest that ED resources facing inappropriate utilization rate, while patients experience significant wait times particularly in the Green Triage Zone. The proposed configuration in this study improved the ED bottlenecks. Based on the comparison of all alternatives, Alternative 4 is recommended as the best alternative. Patients’ wait times reduce by 52%. High utilization rates of Red Zone Doctors, Green Zone Doctors and Yellow Zone Nurses were successfully lowered from 89% to 85%, 98% to 90% and 91% to 89%, respectively. Meanwhile, Yellow Zone Doctor’s poor usage rate increased from 41% to 49%. CONCLUSION: The study’s findings highlight the benefits of the method used and offer key decision makers a decision support tool for resource planning while reducing patients’ wait times and improving ED service quality.