Simulation Overview


	Emergency Department Workflow Simulation

Simulation is a three part process: the design of a model that describes an actual physical system, the execution of this model on a computer, and the analysis of the execution output. In simplest terms, a simulation is a role-play - build artificial objects and act out roles with these objects.

In modeling an Emergency Department, the model would contain patients, physicians and other clinicians, the ED infrastructure, work flows describing the patient arrival time, the patient-physician/clinician interactions, and work flows describing the patient's interactions with Lab/X-ray, diversion criteria, and documentation and admission/discharge processes. Expected or average durations are then assigned for each of the time-based work flows and activities


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Once these entities and interactions are described, a process is executed on a computer which, basically, steps through time. Durations for each time-based workflow and activity are assigned based on an applicable probability distribution. In a simulation of an Emergency Department, output of interest would be individual and aggregate patient data - throughput, arrival times and departure times, abandonment rates - as well individual and aggregate physician data - utilization, interaction times and durations.

The importance of simulation is that any of the dozens of objects, interactions and durations can be revised and the simulation re-run, generating different results. In an Emergency Department, the effects of adding or subtracting a bed or a physician, modifying the length of time to discharge or admit a patient, or increasing or decreasing the rate of patient arrival, is often a matter of great debate, but with little science behind the debate. With simulation, changes to any of those dozens of objects, interactions and durations can be evaluated, often within seconds.

If simulation is so effective, why hasn't it been used more? The answer is, basically, time and money.

It can be very time consuming to develop a model. In most simulation packages, it takes weeks or months to prepare all the various objects and activities.

It can be very difficult to develop a simulation. There's usually significant programming involved and because simulation is such a specialized field, consultants usually need to be hired.

It doesn't take weeks or months to develop a model in "ED Workflow Simulation". All the objects and activities are pre-prepared - the simulation developer need only enter those values that are specific to the Emergency Department being evaluated.

There's no programming involved for the simulation developer. The programming is already implicit within the "ED Simulation" application. A consultant is not required: By pre-building all objects and activities within the application, specialized knowledge of simulations is not required.

With "ED Simulation", development of a detailed Emergency Department simulation takes a few hours, and running the simulation takes a few seconds. The return on investment is usually realized upon the very first "what-if?"


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