Evaluating an Emergency Department Care Redesign: A Simulation Approach

Complex interactions between workload variability, uncertain and increasing arrival rates, and resource constraints make it difficult to improve flow through emergency departments (EDs). This complexity causes crowded EDs, long patient lengths of stay, and burnout among care providers. One way to improve efficiency while maintaining high quality care is to switch from a siloed unit-based department to a team-based design or pod system. This paper seeks to compare a pod system against the unit-based design at Southeastern Health's ED using a discrete event simulation. Robustness of the model under a selection of staffing designs will be tested with increased arrival rates and varying mixes of severity for incoming patients. Ultimately, it is shown the pod system maintains quality of care metrics while increasing resource utilization, establishing proof of concept that an optimized pod system can improve flow in the ED.