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Reducing search times and entropy in hospital emergency departments with real-time location systems

Pendrill, Leslie ; Espinoza, Andreas ; Wadman, Johan ; Nilsask, Fredrik LU ; Wretborn, Jens LU ; Ekelund, Ulf LU orcid and Pahlm, Ulrika LU (2021) In IISE Transactions on Healthcare Systems Engineering 11(4). p.305-315
Abstract

Although the consequences of hospital ED crowding have been studied extensively, the causes of crowding are still not well understood. Throughput factors in ED crowding models are difficult to study in a controlled fashion in a dynamic environment where healthcare demand changes rapidly, and physical and human resources suddenly become limited. Opportunities for automated, simultaneous, and low-cost observation of the location and movement of multiple units, patients and staff have recently arisen with the introduction of small, non-intrusive real-time location systems (RTLS). One such RTLS deployment reported here has initiated renewed consideration of quality and industrial statistics as applied to healthcare operations management.... (More)

Although the consequences of hospital ED crowding have been studied extensively, the causes of crowding are still not well understood. Throughput factors in ED crowding models are difficult to study in a controlled fashion in a dynamic environment where healthcare demand changes rapidly, and physical and human resources suddenly become limited. Opportunities for automated, simultaneous, and low-cost observation of the location and movement of multiple units, patients and staff have recently arisen with the introduction of small, non-intrusive real-time location systems (RTLS). One such RTLS deployment reported here has initiated renewed consideration of quality and industrial statistics as applied to healthcare operations management. Novel metrics for essential constructs of throughput factors in ED crowding such as efficiency and effectiveness are proposed. In particular, causality is explained in terms of understanding of each construct, modeled in terms of entropy, information, and order. Experimental demonstration is given of how labor reduction and the probability of patients, personnel and equipment meeting in terms of less uncertainty can be explained. These novel metrics are expected to facilitate monitoring of how an ED reacts to different levels of crowding, provide insight into crowding dynamics, help evaluate interventions to decrease crowding, and ultimately improve care.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Emergency department, healthcare management, patient flow, process improvement
in
IISE Transactions on Healthcare Systems Engineering
volume
11
issue
4
pages
305 - 315
publisher
Taylor & Francis
external identifiers
  • scopus:85104421523
ISSN
2472-5579
DOI
10.1080/24725579.2021.1881660
language
English
LU publication?
yes
id
f5d90e65-c531-4536-b4f8-2a9ba9d0667e
date added to LUP
2021-05-03 18:25:50
date last changed
2024-02-20 04:20:17
@article{f5d90e65-c531-4536-b4f8-2a9ba9d0667e,
  abstract     = {{<p>Although the consequences of hospital ED crowding have been studied extensively, the causes of crowding are still not well understood. Throughput factors in ED crowding models are difficult to study in a controlled fashion in a dynamic environment where healthcare demand changes rapidly, and physical and human resources suddenly become limited. Opportunities for automated, simultaneous, and low-cost observation of the location and movement of multiple units, patients and staff have recently arisen with the introduction of small, non-intrusive real-time location systems (RTLS). One such RTLS deployment reported here has initiated renewed consideration of quality and industrial statistics as applied to healthcare operations management. Novel metrics for essential constructs of throughput factors in ED crowding such as efficiency and effectiveness are proposed. In particular, causality is explained in terms of understanding of each construct, modeled in terms of entropy, information, and order. Experimental demonstration is given of how labor reduction and the probability of patients, personnel and equipment meeting in terms of less uncertainty can be explained. These novel metrics are expected to facilitate monitoring of how an ED reacts to different levels of crowding, provide insight into crowding dynamics, help evaluate interventions to decrease crowding, and ultimately improve care.</p>}},
  author       = {{Pendrill, Leslie and Espinoza, Andreas and Wadman, Johan and Nilsask, Fredrik and Wretborn, Jens and Ekelund, Ulf and Pahlm, Ulrika}},
  issn         = {{2472-5579}},
  keywords     = {{Emergency department; healthcare management; patient flow; process improvement}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{305--315}},
  publisher    = {{Taylor & Francis}},
  series       = {{IISE Transactions on Healthcare Systems Engineering}},
  title        = {{Reducing search times and entropy in hospital emergency departments with real-time location systems}},
  url          = {{http://dx.doi.org/10.1080/24725579.2021.1881660}},
  doi          = {{10.1080/24725579.2021.1881660}},
  volume       = {{11}},
  year         = {{2021}},
}