%0 Journal Article
%T Strategic emergency department design: An approach to capacity planning in healthcare provision in overcrowded emergency rooms
%A Aristomenis K Exadaktylos
%A Dimitrios S Evangelopoulos
%A Marcel Wullschleger
%A Leo Bščrki
%A Heinz Zimmermann
%J Journal of Trauma Management & Outcomes
%D 2008
%I BioMed Central
%R 10.1186/1752-2897-2-11
%X This paper explores the possibilities offered by dynamic simulation tools to improve patient pathways using the emergency department of a busy university teaching hospital in Switzerland as an example.In the USA and Europe, emergency departments (EDs) are confronted with overcrowding and budget restrictions. The discipline of emergency medicine (EM) has faced significant challenges from its inception to its successful establishment in many countries. Inherent to EM is the need to interact with many other specialties, and the results have been rewarding, disappointing, or questionable to almost equal extents. One of the most consistent frustrations for EM physicians are constantly overcrowded emergency rooms. The profile of the patient population is also changing and is highly dependent on cultural context and developments. Furthermore, there is an increasing need for more information on financial planning and health policy-making [1]. These factors provide a stimulus to analyze and improve internal processes in EDs. Traditionally, such design-relevant problems were solved by means of static (quantitative) estimates, but the use of a qualitative dynamic systems (DS) approach seems to be more appropriate [2].The ED at the Inselspital in Berne, Switzerland, provides round-the-clock medical and surgical care. An increasing patient volume has resulted in difficulty in reaching elective admission and bed occupancy targets. We used data from our department to map the system conceptually based on patient pathways from admission to discharge. Patterns of activity, demand, and system bottlenecks were simulated with this map and used to construct a quantitative DS model. Our goal was to examine whether a DS model approach can help to solve strategic design challenges in emergency department capacity planning, and demonstrate the significance of such a design feature in achieving strategic and political success.Our goal was to solve complex problems within the framework of a pr
%U http://www.traumamanagement.org/content/2/1/11