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首页> 外文期刊>International journal of health care quality assurance >Adjusting patients streaming initiated by a wait time threshold in emergency department for minimizing opportunity cost
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Adjusting patients streaming initiated by a wait time threshold in emergency department for minimizing opportunity cost

机译：调整急诊部门等待时间阈值启动的患者流，以最大程度地降低机会成本

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Purpose - Two different systems for streaming patients were considered to improve efficiency measures such as waiting times (WTs) and length of stay (LOS) for a current emergency department (ED). A typical fast track area (FTA) and a fast track with a wait time threshold (FTW) were designed and compared effectiveness measures from the perspective of total opportunity cost of all patients' WTs in the ED. The paper aims to discuss these issues. Design/methodology/approach - This retrospective case study used computerized ED patient arrival to discharge time logs (between July 1,2009 and June 30,2010) to build computer simulation models for the FTA and fast track with wait time threshold systems. Various wait time thresholds were applied to stream different acuity-level patients. National average wait time for each acuity level was considered as a threshold to stream patients. Findings - The fast track with a wait time threshold (FTW) showed a statistically significant shorter total wait time than the current system or a typical FTA system The patient streaming management would improve the service quality of the ED as well as patients' opportunity costs by reducing the total LOS in the ED. Research limitations/implications - The results of this study were based on computer simulation models with some assumptions such as no transfer times between processes, an arrival distribution of patients, and no deviation of flow pattern. Practical implications - When the streaming of patient flow can be managed based on the wait time before being seen by a physician, it is possible for patients to see a physician within a tolerable wait time, which would result in less crowded in the ED. Originality/value - A new streaming scheme of patients' flow may improve the performance of fast track system.
机译：目的-考虑使用两种不同的流动患者系统来提高效率，例如当前急诊室（ED）的等待时间（WTs）和住院时间（LOS）。设计了典型的快速通道区域（FTA）和带有等待时间阈值的快速通道（FTW），并从急诊室中所有患者WT的总机会成本角度比较了有效性指标。本文旨在讨论这些问题。设计/方法/方法-这项回顾性案例研究使用计算机化ED患者到达来记录出院时间日志（2009年7月1日至2010年6月30日之间），以建立FTA的计算机仿真模型并使用等待时间阈值系统进行快速跟踪。应用了各种等待时间阈值来传输不同的敏锐度患者。各个视力水平的全国平均等待时间被认为是患者入院的门槛。调查结果-具有等待时间阈值（FTW）的快速通道显示，与当前系统或典型FTA系统相比，具有统计上显着缩短的总等待时间。患者流管理将通过以下方式提高ED的服务质量以及患者的机会成本：减少急诊室的总服务水平。研究的局限性/意义-这项研究的结果基于计算机模拟模型，并带有一些假设，例如过程之间没有转移时间，患者的到达分布以及流型没有偏差。实际意义-如果可以在医师看病之前根据等待时间来管理患者流量，则患者有可能在可忍受的等待时间内就诊，这将减少ED的拥挤。原创性/价值-一种新的患者流传输方案可以改善快速通道系统的性能。

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