Emergency department process flow improvement based on efficient architectural layout, lean concept and post-lean simulation.

摘要

Long waiting times in Emergency Departments (ED) have been an issue in Canadian hospitals for years. Many factors have contributed to the excessive waiting time, including the current design scheme which is known architecturally as the “Funnel Design Scheme.” Current architectural and engineering practice lacks standards to quantify the effect of ED design and ancillary departments on waiting time and Length of Stay (LOS). This research focuses on assessing the architectural standards of ED on the basis of a patient-focused environment. The objective is to optimize the space requirement to reduce waiting time following what is called “universal zero delay treatment.” The proposed methodology uses two techniques: a) a statistical analysis of forty two ED architectural designs, and b) the application of Lean Healthcare combined with Post Lean Simulation which offers an opportunity to evaluate the potential impact of different interventions on patient flow and throughput. The proposed methodology is tested through a case study and interviews with healthcare professionals.