Reducing Length of Stay in Emergency Department: A Simulation Study at a Community Hospital

In this paper, a simulation model of an emergency department (ED) at a large community hospital, Central Baptist Hospital in Lexington, KY, is developed. Using such a model, we can accurately emulate the patient flow in the ED and carry out sensitivity analysis to determine the most critical process for improvement in quality of care (in terms of patient length of stay). In addition, a what-if analysis is performed to investigate the potential change in operation policies and its impact. Floating nurse, combining registration with triage, mandatory requirement of physician's visit within 30 min, and simultaneous reduction of operation times of some most sensitive procedures can all result in substantial improvement. These recommendations have been submitted to the hospital leadership, and implementations are in progress.