Optimizing Emergency Department Patient Flow Through Bed Allocation Strategies: A Discrete-Event Simulation Study.

Emergency department (ED) overcrowding and prolonged length of stay (LOS) remain critical issues in healthcare systems. This study compared 4 bed allocation strategies to optimize patient flow and resource utilization in a regional teaching hospital in Taiwan. A discrete-event simulation model was d...

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Publicado en:Inquiry (00469580) Vol. 62; pp. 1 - 10
Autores principales: Wang, Sen-Tian, Weng, Shao-Jen, Yeh, Ting-Yu, Chen, Chih-Hao, Tsai, Yao-Te
Formato: algorithm research tables/charts Journal Article
Publicado: Sage Publications Inc. 4/29/2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 4/29/2025
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        atl: Optimizing Emergency Department Patient Flow Through Bed Allocation Strategies: A Discrete-Event Simulation Study.
      aug:
        au:
          Wang, Sen-Tian
          Weng, Shao-Jen
          Yeh, Ting-Yu
          Chen, Chih-Hao
          Tsai, Yao-Te
        affil: Chang Bing Show-Chwan Memorial Hospital, Changhua, Taiwan
      sug:
        subj:
          Emergency Room Visits
          Bed Occupancy
          Health Resource Allocation
          Length of Stay
          Waiting Lists
          Patient Admission
          Academic Medical Centers Taiwan
          Human
          Emergency Patients
          Emergency Service
          Inpatients
          Taiwan
          Multicenter Studies
          Retrospective Design
          Record Review
          Health Facility Environment
          Comparative Studies
          Descriptive Statistics
          Organizational Efficiency
          Crowding
          Funding Source
      ab: Emergency department (ED) overcrowding and prolonged length of stay (LOS) remain critical issues in healthcare systems. This study compared 4 bed allocation strategies to optimize patient flow and resource utilization in a regional teaching hospital in Taiwan. A discrete-event simulation model was developed using 1 year hospital data from January 2022, including 29 718 ED visits. The following strategies were evaluated: (1) intra-departmental bed sharing, (2) optimized bed allocation, (3) cross-departmental bed lending with 5% capacity, and (4) combined optimization with bed borrowing. The model was validated by t -tests comparing the simulation outputs with actual hospital data. Results: All strategies demonstrated improvement compared to current operations. Of these, Strategy 4, combined optimization with bed borrowing, was the most promising: it maintained stable ED nursing utilization at 45.65% with a 95% confidence interval (CI) of 45.60% to 45.71% while reducing the cases of extended LOS. The rates of ED LOS exceeding 6, 12, and 24 h were 2.48%, 0.38%, and 0.12%, respectively, which is a significant improvement compared with the baseline. Optimization alone contributed to a 20% improvement in extended LOS under Strategy 2, while additional bed-sharing policies further improved performance by 10%. Conclusions: Strategic bed allocation combined with controlled bed-sharing policies achieved a 30% reduction in extended ED LOS without increasing nursing workload. The optimal strategy (Strategy 4) reduced cases of ED LOS exceeding 6 h to 2.48% while maintaining stable nursing utilization at 45.65%, demonstrating the effectiveness of combining optimization with resource sharing in ED patient flow management.
      pubtype: Academic Journal
      doctype:
        algorithm
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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