A Queueing Network Model of Patient Flow in an Accident and Emergency.pdf

A Queueing Network Model of Patient Flow in an Accident and Emergency.pdf

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A Queueing Network Model of Patient Flow in an Accident and Emergency

A Queueing Network Model of Patient Flow in an Accident and Emergency Department S.W.M. Au-Yeung, P.G. Harrison and W.J. Knottenbelt Department of Computing Imperial College London, SW7 2AZ, UK August 15, 2006 ABSTRACT In many complex processing systems with limited re- sources, fast response times are demanded, but are sel- dom delivered. This is an especially serious problem in healthcare systems providing critical patient care. In this paper, we develop a multiclass Markovian queueing network model of patient flow in the Accident and Emer- gency department of a major London hospital. Using real patient timing data to help parameterise the model, we solve for moments and probability density functions of patient response time using discrete event simulation. We experiment with different patient handling priority schemes and compare the resulting response time mo- ments and densities with real data. Introduction It is a goal universally acknowledged that a healthcare system should treat its patients – and especially those in need of critical care – in a timely manner. How- ever, this is often not achieved in practice, particularly in state-run public healthcare systems that suffer from high patient demand and limited resources. In the United Kingdom, there has been much public concern regarding patient waiting times in the National Health Service (NHS). For example, in a recent King’s Fund report, improved waiting times for patients in Ac- cident and Emergency departments and for cancer and cardiac patients are identified as two of the public’s top four priorities for public healthcare in the UK [9]. In response, the UK government has introduced perfor- mance targets for the NHS, many of which are driven by response times – in 2004/2005 NHS performance rat- ings were based on eight key targets, six of which in- volved patient waiting and treatment times. Currently NHS Trusts are assessed against a broader set of core standards, but these still incorporate existing r

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