Applying Systems Engineering Tools to Measure and Improve Hospital-Based Health Care Delivery

Abstract

Patient safety and emergency department functionality are compromised when inefficient coordination between hospital departments impedes ED patients’ access to inpatient cardiac care. The objective of this dissertation was to create a discrete event simulation model of hospital patient flow in order to determine how bed demand from competing cardiology admission sources affects ED patients’ access to inpatient cardiac care. The simulation employed survival analysis regression to model competition for inpatient cardiac beds and predict delays in ED patients’ access. The novel simulation strategy was used to demonstrate how altering outpatient schedules and creating informed bed management practices can optimize hospital capacity and improve ED patient access and how interventions designed to increase inpatient throughput or add capacity will have the most significant effect on highest priority patients.