Facets of operational performance in an emergency room (ER)

Taco Van Der Vaart, G. Vastag, Jacob Wijngaard

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

This paper, using detailed time measurements of patients complemented by interviews with hospital management and staff, examines three facets of an emergency room's (ER) operational performance: (1) effectiveness of the triage system in rationing patient treatment; (2) factors influencing ER's operational performance in general and the trade-offs in flow times, inventory levels (that is the number of patients waiting in the system), and resource utilization; (3) the impacts of potential process and staffing changes to improve the ER's performance. Specifically, the paper discusses four proposals for streamlining the patient flow: establishing designated tracks (fast track, diagnostic track), creating a holding area for certain type of patients, introducing a protocol that would reduce the load on physicians by allowing a registered nurse to order testing and treatment for some patients, and potentially and in the longer term, moving from non-ER specialist physicians to ER specialists. The paper's findings are based on analyzing the paths and flow times of close to two thousand patients in the emergency room of the Medical Center of Leeuwarden (MCL), The Netherlands. Using exploratory data analysis the paper presents generalizable findings about the impacts of various factors on ER's lead-time performance and shows how the proposals fit with well-documented process improvement theories.

Original languageEnglish
Pages (from-to)201-211
Number of pages11
JournalInternational Journal of Production Economics
Volume133
Issue number1
DOIs
Publication statusPublished - Sep 2011

Fingerprint

Emergency rooms
Patient treatment
Time measurement
Lead
Testing
Emergency
Business performance

Keywords

  • Capacity and lead time analysis
  • Emergency care
  • Exploratory data analysis
  • Services
  • Work-in-process inventories

ASJC Scopus subject areas

  • Industrial and Manufacturing Engineering
  • Business, Management and Accounting(all)
  • Management Science and Operations Research
  • Economics and Econometrics

Cite this

Facets of operational performance in an emergency room (ER). / Van Der Vaart, Taco; Vastag, G.; Wijngaard, Jacob.

In: International Journal of Production Economics, Vol. 133, No. 1, 09.2011, p. 201-211.

Research output: Contribution to journalArticle

Van Der Vaart, Taco ; Vastag, G. ; Wijngaard, Jacob. / Facets of operational performance in an emergency room (ER). In: International Journal of Production Economics. 2011 ; Vol. 133, No. 1. pp. 201-211.
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