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Emergency Departments: “Repairs While You Wait, No Appointment Necessary”

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Part of the book series: International Series in Operations Research & Management Science ((ISOR,volume 184))

Abstract

In this chapter we focus on the detailed, operational modeling of Emergency Departments—the flows and general processes, and not on clinical decision making. On the flow level, an Emergency Department shares a number of characteristics with a general repair shop, and while there are key differences, the flow and resource interrelationships are similar. We use this perspective to assist researchers with the decomposition and analysis of Emergency Departments, as well as the review of detailed research on Emergency Departments. We examine the scope of research efforts, methodologies employed, types of data included in the modeling, and the implementation of research results in practice. The chapter is anchored by an extensive field study at a medium-sized Emergency Department, whose methodology and key results are presented along with insights from the hospital.

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Notes

  1. 1.

    Terminology is also a factor in performing literature searches on this topic. For example, various terms are used to describe the functionality and include emergency room, Emergency Department, trauma unit, medical assessment unit, and accident and emergency unit. Spelling is an additional issue with terms such as queuing and queueing. Phrasing is also important as queuing theory versus queuing model will provide different results. These are just the English language semantics and do not address the challenges associated with research disseminated in different languages.

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Acknowledgements

The chapter has benefited from the critical suggestions of the reviewers and by Dr. Blair Egerdie, Gary Black, Fatih Erenay, John Buzacott, Reha Uzsoy, and Brian Denton. Their suggestions have been very insightful and beneficial. The chapter would not have been possible without the tremendous support and assistance of the hospital and the people working in the Emergency Department. During the study the analysis team received a great deal of help from the nurses, clerks, porters, and physicians. Additional valuable assistance came from other units in the hospital as well. The analysis team consisted of Jennifer Engels, Sahil Jain, and Kenneth McKay. At the time of the study, Jennifer Engels was completing her MASc and volunteered to be a research assistant on the project. Sahil Jain was a senior medical student and participated in the study as part of his educational program.

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Authors and Affiliations

  1. Department of Management Sciences, University of Waterloo, Waterloo, ON, Canada

    Kenneth N. McKay

  2. Manulife Financial Corporation, Business System Analyst, Kitchener, ON, Canada

    Jennifer E. Engels

  3. Toronto, ON, Canada

    Sahil Jain MD (Consultant)

  4. VP Quality and Performance Management, St. Mary’s General Hospital, Kitchener, ON, Canada

    Lydia Chudleigh

  5. St. Mary’s General Hospital, Kitchener, ON, Canada

    Don Shilton (President)

  6. St. Mary’s General Hospital, Grand River Hospital, Joint Chief of Staff, Kitchener, ON, Canada

    Ashok Sharma MD

Authors
  1. Kenneth N. McKay
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  2. Jennifer E. Engels
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  3. Sahil Jain MD
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  4. Lydia Chudleigh
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  5. Don Shilton
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  6. Ashok Sharma MD
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Correspondence to Kenneth N. McKay .

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Editors and Affiliations

  1. , IOE Department, University of Michigan, Beal Ave 1205, Ann Arbor, 48109, Michigan, USA

    Brian T. Denton

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McKay, K.N., Engels, J.E., Jain, S., Chudleigh, L., Shilton, D., Sharma, A. (2013). Emergency Departments: “Repairs While You Wait, No Appointment Necessary”. In: Denton, B. (eds) Handbook of Healthcare Operations Management. International Series in Operations Research & Management Science, vol 184. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5885-2_13

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