When to Use Provider Triage in Emergency Departments

被引:8
作者
Kamali, Michael F. [1 ]
Tezcan, Tolga [2 ]
Yildiz, Ozlem [3 ]
机构
[1] Univ Rochester, Med Ctr, Rochester, NY 14642 USA
[2] London Business Sch, London NW1 4SA, England
[3] Univ Virginia, Darden Sch Business, Charlottesville, VA 22903 USA
基金
美国国家科学基金会;
关键词
healthcare; hospitals; probability; stochastic model applications; queues; approximations; AMBULANCE DIVERSION; WAITING TIME; IMPACT; PHYSICIAN; QUEUE; ADMISSIONS; OCCUPANCY; CARE;
D O I
10.1287/mnsc.2017.2982
中图分类号
C93 [管理学];
学科分类号
12 ; 1201 ; 1202 ; 120202 ;
摘要
We study triage decisions in emergency departments (EDs) and provide a general procedure for determining when to apply provider triage (PT) based on operational and financial considerations using a steady-state, many-server fluid approximation. We then apply the proposed method in the setting of a teaching hospital's ED and obtain closed-form expressions for the range of arrival rates for which PT outperforms the traditional nurse triage economically. We show that the proposed solution methodology based on this approximation procedure is asymptotically optimal under a many-server asymptotic regime. We also demonstrate via simulation experiments that the proposed policy performs within 0.82% of the best solution obtained via a computationally intensive total enumeration method.
引用
收藏
页码:1003 / 1019
页数:17
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