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Title: | Improving emergency department performance by revising the patient-physician assignment process | Authors: | VANBRABANT, Lien BRAEKERS, Kris RAMAEKERS, Katrien |
Issue Date: | 2021 | Publisher: | SPRINGER | Source: | Flexible services and manufacturing journal (Print), 33 (3), p. 783-845 | Abstract: | Emergency departments (EDs) are continuously exploring opportunities to improve their efficiency. A new opportunity lies in revising the patient-physician assignment process by limiting the number of patients simultaneously assigned to a single physician, which is defined as the application of a case manager approach with limited caseloads. The potential of introducing a case manager approach with limited caseloads as a way to improve physician productivity, and consequently ED performance, is investigated by use of a discrete-event simulation model based on a real-life case study. In addition, as the case manager system is characterised by three parameters that can be customised and optimised (i.e. caseload limit, pre-assignment queueing discipline and internal queueing discipline), the impact of these parameters on the effectiveness to improve ED performance in terms of length-of-stay and door-to-doctor time is evaluated. To the best of our knowledge, this paper is the first to examine the potential of a case manager system with limited caseloads in a complex service system like a real-life ED, and to investigate the impact of the three system parameters on the results. The outcomes of the study show that performance can be improved significantly by introducing a case manager system, and that the system parameters have an impact on the effect size. | Keywords: | Discrete-event simulation;Emergency department;Case managers;Real-life case study;Healthcare operations | Document URI: | http://hdl.handle.net/1942/31721 | ISSN: | 1936-6582 | e-ISSN: | 1936-6590 | DOI: | 10.1007/s10696-020-09388-2 | ISI #: | WOS:000540956000001 | Rights: | Springer Science+Business Media, LLC, part of Springer Nature 2020 | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2021 |
Appears in Collections: | Research publications |
Files in This Item:
File | Description | Size | Format | |
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FLEX-D-19-00186_R1 (2).pdf | Peer-reviewed author version | 3.17 MB | Adobe PDF | View/Open |
s10696-020-09388-2.pdf Restricted Access | Published version | 2.9 MB | Adobe PDF | View/Open Request a copy |
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