TY - JOUR
T1 - Application of queuing theory to optimize the triage process in a tertiary emergency care ('ER') department
AU - Moreno-Carrillo, Atilio
AU - Arenas, Lina
AU - Fonseca, Julián
AU - Caicedo, Camilo
AU - Tovar, Sandra
AU - Muñoz-Velandia, Oscar Mauricio
N1 - Publisher Copyright:
© 2019 Journal of Emergencies, Trauma, and Shock.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Context: Time from triage to patient care is usually evaluated, but time elapsed between the arrival of patient to emergency room (ER) and triage (pretriage) is not usually measured. Aims: The present study evaluates how the application of the queuing (or 'waiting line') theory in the triage process can generate effective strategies to improve patient care in the ER. Settings and Design: A 'before-and-after' study was conducted in the ER of the Hospital Universitario San Ignacio, a tertiary emergency care in Bogotá, Colombia. Subjects and Methods: The pretriage time was evaluated, and queuing theory was applied to the evaluation; according to the results, the number and distribution of the necessary nursing personnel were determined. Statistical Analysis Used: The change in waiting times was compared using a paired t-test. Results: In a first 7 months evaluation period, 89,898 patient visits were considered, with an average pretriage time of 22.15 min. According to the arrival distribution by hours and days of the week and considering the results of the calculations made using queuing theory, the number of nurses needed in the service per hour was determined for each day of the week, and schedule changes were implemented without increasing staff. In a second similar evaluation period, 94,497 patient visits were considered demonstrating a reduction of the pretriage time to 7.5 min (mean difference 14.64 min, 95% confidence interval 14.42-14.85, P < 0.001). Conclusions: The use of queuing theory in the planning of the daily personnel requirements in the triage area of ER can reduce the pretriage time by 65% without incurring additional cost.
AB - Context: Time from triage to patient care is usually evaluated, but time elapsed between the arrival of patient to emergency room (ER) and triage (pretriage) is not usually measured. Aims: The present study evaluates how the application of the queuing (or 'waiting line') theory in the triage process can generate effective strategies to improve patient care in the ER. Settings and Design: A 'before-and-after' study was conducted in the ER of the Hospital Universitario San Ignacio, a tertiary emergency care in Bogotá, Colombia. Subjects and Methods: The pretriage time was evaluated, and queuing theory was applied to the evaluation; according to the results, the number and distribution of the necessary nursing personnel were determined. Statistical Analysis Used: The change in waiting times was compared using a paired t-test. Results: In a first 7 months evaluation period, 89,898 patient visits were considered, with an average pretriage time of 22.15 min. According to the arrival distribution by hours and days of the week and considering the results of the calculations made using queuing theory, the number of nurses needed in the service per hour was determined for each day of the week, and schedule changes were implemented without increasing staff. In a second similar evaluation period, 94,497 patient visits were considered demonstrating a reduction of the pretriage time to 7.5 min (mean difference 14.64 min, 95% confidence interval 14.42-14.85, P < 0.001). Conclusions: The use of queuing theory in the planning of the daily personnel requirements in the triage area of ER can reduce the pretriage time by 65% without incurring additional cost.
KW - Emergency
KW - queuing theory
KW - triage
UR - http://www.scopus.com/inward/record.url?scp=85075501445&partnerID=8YFLogxK
U2 - 10.4103/JETS.JETS_42_19
DO - 10.4103/JETS.JETS_42_19
M3 - Article
AN - SCOPUS:85075501445
SN - 0974-2700
VL - 12
SP - 268
EP - 273
JO - Journal of Emergencies, Trauma and Shock
JF - Journal of Emergencies, Trauma and Shock
IS - 4
ER -