Use of a simulation-based decision support tool to improve emergency department throughput

A simulation based decision support model was used in the redesign of an emergency department (ED) with close to 180,000 visits per year. In order to accommodate high patient volumes at a single site ED, improving patient throughput time is necessary to maintain operational efficiency and to provide high quality patient care. A throughput time goal of arrival to departure under 3 h for 80% of ED patients was selected as the redesign project objective. Using discrete event simulation modeling, target areas for improvement are identified including optimized process flow, resource allocation and operational policies. Simulation modeling allows ED leadership to make decisions on operational changes using quantitative information of the impact of what-if scenarios on key performance measures. Based on simulation data results, changes in ED processes were implemented that resulted in 81% of patients having a length of stay in the ED of less than 3 h; a 30% improvement in average patient length of stay.