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Setting staffing requirements for time-dependent queueing networks: the case of accident and emergency departments

Setting staffing requirements for time-dependent queueing networks: the case of accident and emergency departments
Setting staffing requirements for time-dependent queueing networks: the case of accident and emergency departments
An incentive scheme aimed at reducing patients’ waiting times in accident and emergency departments was introduced by the UK government in 2000. It requires 98% of patients to be discharged, transferred, or admitted to inpatient care within 4 hours of arrival. Setting the minimal hour by hour medical staffing levels for achieving the government target, in the presence of complexities like time-varying demand, multiple types of patients, and resource sharing, is the subject of this paper. Building on extensive body of research on time dependent queues, we propose an iterative scheme which uses infinite server networks, the square root staffing law, and simulation to come up with a good solution. The implementation of this algorithm in a typical A&E department suggests that significant improvement on the target can be gained, even without increase in total staff hours
staffing emergency departments, 98% target, time-dependent queues, simulation
0377-2217
531-540
Izady, Navid
bca6a7c0-064b-4502-a273-5645723a0b02
Worthington, Dave
c6eaf499-7379-4fef-92b3-fed7bf9e77f4
Izady, Navid
bca6a7c0-064b-4502-a273-5645723a0b02
Worthington, Dave
c6eaf499-7379-4fef-92b3-fed7bf9e77f4

Izady, Navid and Worthington, Dave (2012) Setting staffing requirements for time-dependent queueing networks: the case of accident and emergency departments. [in special issue: Operations Research in Health Care. EURO XXIII, 5-8 July 2009, Bonn. The Past and Present of Optimization. EURO XXIV, 11-14 July 2010, Lisbon] European Journal of Operational Research, 219 (3), 531-540. (doi:10.1016/j.ejor.2011.10.040).

Record type: Article

Abstract

An incentive scheme aimed at reducing patients’ waiting times in accident and emergency departments was introduced by the UK government in 2000. It requires 98% of patients to be discharged, transferred, or admitted to inpatient care within 4 hours of arrival. Setting the minimal hour by hour medical staffing levels for achieving the government target, in the presence of complexities like time-varying demand, multiple types of patients, and resource sharing, is the subject of this paper. Building on extensive body of research on time dependent queues, we propose an iterative scheme which uses infinite server networks, the square root staffing law, and simulation to come up with a good solution. The implementation of this algorithm in a typical A&E department suggests that significant improvement on the target can be gained, even without increase in total staff hours

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e-pub ahead of print date: 10 November 2011
Published date: 16 June 2012
Keywords: staffing emergency departments, 98% target, time-dependent queues, simulation
Organisations: Operational Research

Identifiers

Local EPrints ID: 176781
URI: http://eprints.soton.ac.uk/id/eprint/176781
ISSN: 0377-2217
PURE UUID: 74f5ff99-3bdf-4cb5-9aec-77cee5cc24e6

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Date deposited: 11 Mar 2011 09:41
Last modified: 16 Dec 2019 20:50

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Author: Navid Izady
Author: Dave Worthington

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