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Introduction: “Crowding” in Emergency Rooms (ER) is a worldwide phenomenon with many implications. It has a negative impact mainly on patient care. The phenomenon is also found in Greece and in combination with the structural problems of the Greek Health System, it creates additional pressure on the ER. Purpose: To study the phenomenon of "crowding" it is suggested to use simulation as a basic tool. The aim is to study ΕR as a system, to find bottlenecks, and to develop scenarios of improvement. The main hypothesis of this work is that the study and modeling of ER processes can help to understand the elements that influence “crowding” and help develop tools and practices to address this phenomenon. Material and Method: The method followed is to develop a Discrete Event Simulation (DES) model using the ClouDES simulation platform. The methodology is designed to work with minimal ER data. In order to put the model into practice, a collaboration was developed with the Emergency Rooms of the Athens General Hospital “Hippocrates”. Results: The simulation results confirm that the ER is “crowded” and highlight critical bottlenecks (triage, laboratory tests, large number of non-emergencies). Conclusions: Modeling and simulation are powerful tools that can help study the phenomenon of "crowding". Experimentation with improvement scenarios indicates that actions to improve the functioning of ER need interventions, both within ERs (eg 24-hour, etc.) and outside ER (eg enhancing Primary Health Care, etc.).
|Category:||Volume 59, N 4|
|Authors:||Panagiota Bougatsa , Ioannis Apostolakis , George Charalambous|