Modeling and analysis of the emergency department at University of Kentucky Chandler Hospital using simulations

J Emerg Nurs. 2010 Jul;36(4):303-10. doi: 10.1016/j.jen.2009.07.018. Epub 2009 Sep 15.


Introduction: In this article, we present a simulation study conducted in the emergency department at the University of Kentucky Chandler Hospital.

Methods: Based on analysis of process and flow data, a simulation model of patient throughput in the emergency department has been developed.

Results: What-if analyses have been proposed to identify bottlenecks and investigate the optimal numbers of human and equipment resources (eg, nurses, physicians, and radiology technology). The simulation results suggest that 3 additional nurses are needed to ensure desired clinical outcomes. Diagnostic testing, the computed tomography scan in particular, is found to be a bottleneck. As a result, acquisition of an additional computed tomography scanner is recommended. Hospital management has accepted the recommendations, and implementation is in progress.

Discussion: Such a model provides a quantitative tool for continuous improvement and process control in the emergency department and also is applicable to other departments in the hospital.

MeSH terms

  • Algorithms
  • Ancillary Services, Hospital / statistics & numerical data
  • Ancillary Services, Hospital / supply & distribution
  • Appointments and Schedules
  • Computer Simulation*
  • Emergency Nursing*
  • Emergency Service, Hospital / organization & administration*
  • Hospitals, University / organization & administration*
  • Humans
  • Personnel Staffing and Scheduling
  • Tomography, X-Ray Computed / statistics & numerical data
  • Workflow*
  • Workforce