Methodological approaches to support process improvement in emergency departments: a systematic review

The most commonly used techniques for addressing each Emergency Department (ED) problem (overcrowding, prolonged waiting time, extended length of stay, excessive patient flow time, and high left-without-being-seen (LWBS) rates) were specified to provide healthcare managers and researchers with a use...

Full description

Autores:
Ortiz Barrios, Miguel Angel
Alfaro-Saíz, Juan-José
Tipo de recurso:
Article of journal
Fecha de publicación:
2020
Institución:
Corporación Universidad de la Costa
Repositorio:
REDICUC - Repositorio CUC
Idioma:
eng
OAI Identifier:
oai:repositorio.cuc.edu.co:11323/6244
Acceso en línea:
https://hdl.handle.net/11323/6244
https://doi.org/10.3390/ijerph17082664
https://repositorio.cuc.edu.co/
Palabra clave:
Healthcare
Emergency department
Process improvement
Systematic review
Rights
openAccess
License
CC0 1.0 Universal
id RCUC2_ec49feb14595b6f8a7950b7f8a096e30
oai_identifier_str oai:repositorio.cuc.edu.co:11323/6244
network_acronym_str RCUC2
network_name_str REDICUC - Repositorio CUC
repository_id_str
dc.title.spa.fl_str_mv Methodological approaches to support process improvement in emergency departments: a systematic review
title Methodological approaches to support process improvement in emergency departments: a systematic review
spellingShingle Methodological approaches to support process improvement in emergency departments: a systematic review
Healthcare
Emergency department
Process improvement
Systematic review
title_short Methodological approaches to support process improvement in emergency departments: a systematic review
title_full Methodological approaches to support process improvement in emergency departments: a systematic review
title_fullStr Methodological approaches to support process improvement in emergency departments: a systematic review
title_full_unstemmed Methodological approaches to support process improvement in emergency departments: a systematic review
title_sort Methodological approaches to support process improvement in emergency departments: a systematic review
dc.creator.fl_str_mv Ortiz Barrios, Miguel Angel
Alfaro-Saíz, Juan-José
dc.contributor.author.spa.fl_str_mv Ortiz Barrios, Miguel Angel
Alfaro-Saíz, Juan-José
dc.subject.spa.fl_str_mv Healthcare
Emergency department
Process improvement
Systematic review
topic Healthcare
Emergency department
Process improvement
Systematic review
description The most commonly used techniques for addressing each Emergency Department (ED) problem (overcrowding, prolonged waiting time, extended length of stay, excessive patient flow time, and high left-without-being-seen (LWBS) rates) were specified to provide healthcare managers and researchers with a useful framework for effectively solving these operational deficiencies. Finally, we identified the existing research tendencies and highlighted opportunities for future work. We implemented the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology to undertake a review including scholarly articles published between April 1993 and October 2019. The selected papers were categorized considering the leading ED problems and publication year. Two hundred and three (203) papers distributed in 120 journals were found to meet the inclusion criteria. Furthermore, computer simulation and lean manufacturing were concluded to be the most prominent approaches for addressing the leading operational problems in EDs. In future interventions, ED administrators and researchers are widely advised to combine Operations Research (OR) methods, quality-based techniques, and data-driven approaches for upgrading the performance of EDs. On a different tack, more interventions are required for tackling overcrowding and high left-without-being-seen rates
publishDate 2020
dc.date.accessioned.none.fl_str_mv 2020-04-29T20:47:40Z
dc.date.available.none.fl_str_mv 2020-04-29T20:47:40Z
dc.date.issued.none.fl_str_mv 2020-04-03
dc.type.spa.fl_str_mv Artículo de revista
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_2df8fbb1
dc.type.coar.spa.fl_str_mv http://purl.org/coar/resource_type/c_6501
dc.type.content.spa.fl_str_mv Text
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/article
dc.type.redcol.spa.fl_str_mv http://purl.org/redcol/resource_type/ART
dc.type.version.spa.fl_str_mv info:eu-repo/semantics/acceptedVersion
format http://purl.org/coar/resource_type/c_6501
status_str acceptedVersion
dc.identifier.issn.spa.fl_str_mv 1661-7827
1660-4601
dc.identifier.uri.spa.fl_str_mv https://hdl.handle.net/11323/6244
dc.identifier.doi.spa.fl_str_mv https://doi.org/10.3390/ijerph17082664
dc.identifier.instname.spa.fl_str_mv Corporación Universidad de la Costa
dc.identifier.reponame.spa.fl_str_mv REDICUC - Repositorio CUC
dc.identifier.repourl.spa.fl_str_mv https://repositorio.cuc.edu.co/
identifier_str_mv 1661-7827
1660-4601
Corporación Universidad de la Costa
REDICUC - Repositorio CUC
url https://hdl.handle.net/11323/6244
https://doi.org/10.3390/ijerph17082664
https://repositorio.cuc.edu.co/
dc.language.iso.none.fl_str_mv eng
language eng
dc.relation.references.spa.fl_str_mv 1. Soril, L.J.J.; Leggett, L.E.; Lorenzetti, D.L.; Noseworthy, T.W.; Clement, F.M. Reducing frequent visits to the emergency department:A systematic review of interventions. PLoS ONE 2015, 10, e0123660. [CrossRef] [PubMed]
2. Jarvis, P.R.E. Improving emergency department patient flow. Clin. Exp. Emerg. Med. 2016, 3, 63. [CrossRef] [PubMed]
3. Emergency Department Quality Improvement: Transforming the Delivery of Care. Available online: https://www.healthcatalyst.com/insights/emergency-department-quality-improvement-transformingdelivery-care (accessed on 20 March 2020).
4. Migita, R.; Yoshida, H.; Rutman, L.; Woodward, G.A. Quality Improvement Methodologies: Principles and Applications in the Pediatric Emergency Department. Pediatr. Clin. N. Am. 2018, 65, 1283–1296. [CrossRef] [PubMed]
5. Holden, R.J. Lean thinking in emergency departments: A critical review. Ann. Emerg. Med. 2011, 57, 265–278. [CrossRef] [PubMed]
6. Mazzocato, P.; Savage, C.; Brommels, M.; Aronsson, H.; Thor, J. Lean thinking in healthcare: A realist review of the literature. Qual. Saf. Health Care 2010, 19, 376–382. [CrossRef]
7. Günal, M.M.; Pidd, M. Discrete event simulation for performance modelling in health care: A review of the literature. J. Simul. 2010, 4, 42–51. [CrossRef]
8. Paul, S.A.; Reddy, M.C.; Deflitch, C.J. A systematic review of simulation studies investigating emergency department overcrowding. Simulation 2010, 86, 559–571. [CrossRef]
9. Vanbrabant, L.; Braekers, K.; Ramaekers, K.; Van Nieuwenhuyse, I. Simulation of emergency department operations: A comprehensive review of KPIs and operational improvements. Comput. Ind. Eng. 2019, 131, 356–381. [CrossRef]
10. Saghafian, S.; Austin, G.; Traub, S.J. Operations research/management contributions to emergency department patient flow optimization: Review and research prospects. IIE Trans. Healthc. Syst. Eng. 2015, 5, 101–123. [CrossRef]
11. Althaus, F.; Paroz, S.; Hugli, O.; Ghali, W.A.; Daeppen, J.; Peytremann-Bridevaux, I.; Bodenmann, P. Effectiveness of interventions targeting frequent users of emergency departments: A systematic review. Ann. Emerg. Med. 2011, 58, 41–52. [CrossRef]
12. Flores-Mateo, G.; Violan-Fors, C.; Carrillo-Santisteve, P.; Peiró, S.; Argimon, J. Effectiveness of organizational interventions to reduce emergency department utilization: A systematic review. PLoS ONE 2012, 7, 1 – 7. [CrossRef] [PubMed]
13. Boyle, A.; Beniuk, K.; Higginson, I.; Atkinson, P. Emergency Department Crowding: Time for Interventions and Policy Evaluations. Emerg. Med. Int. 2012, 2012, 1–8. [CrossRef] [PubMed]
14. Crawford, K.; Morphet, J.; Jones, T.; Innes, K.; Griffiths, D.; Williams, A. Initiatives to reduce overcrowding and access block in Australian emergency departments: A literature review. Collegian 2014, 21, 359–366. [CrossRef] [PubMed]
15. Uscher-Pines, L.; Pines, J.; Kellermann, A.; Gillen, E.; Mehrotra, A. Deciding to Visit the Emergency Departement for Non-Urgent Conditions: A Systematic Review of the Literature. Am. J. Manag. Care 2013, 19, 47.
16. Oredsson, S.; Jonsson, H.; Rognes, J.; Lind, L.; Göransson, K.E.; Ehrenberg, A.; Asplund, K.; Castrén, M.; Farrohknia, N. A systematic review of triage-related interventions to improve patient flow in emergency departments. Scand. J. Trauma Resusc. Emerg. Med. 2011, 19. [CrossRef]
17. Clarey, A.J.; Cooke, M.W. Patients who leave emergency departments without being seen: Literature review and English data analysis. Emerg. Med. J. 2012, 29, 617–621. [CrossRef]
18. Marcozzi, D.; Carr, B.; Liferidge, A.; Baehr, N.; Browne, B. Trends in the Contribution of Emergency Departments to the Provision of Hospital-Associated Health Care in the USA. Int. J. Health Serv. 2018, 48, 267–288. [CrossRef]
19. Bellow, A.A.; Gillespie, G.L. The evolution of ED crowding. J. Emerg. Nurs. 2014, 40, 153–160. [CrossRef]
20. Ashour, O.M.; Okudan Kremer, G.E. Dynamic patient grouping and prioritization: A new approach to emergency department flow improvement. Health Care Manag. Sci. 2016, 19, 192–205. [CrossRef]
21. Tiwari, Y.; Goel, S.; Singh, A. Arrival time pattern and waiting time distribution of patients in the emergency outpatient department of a tertiary level health care institution of North India. J. Emerg. Trauma Shock 2014, 7, 160–165.
22. Driesen, B.E.J.M.; Van Riet, B.H.G.; Verkerk, L.; Bonjer, H.J.; Merten, H.; Nanayakkara, P.W.B. Long length of stay at the emergency department is mostly caused by organisational factors outside the influence of the emergency department: A root cause analysis. PLoS ONE 2018, 13, 1–15. [CrossRef] [PubMed]
23. Mason, S.; Weber, E.J.; Coster, J.; Freeman, J.; Locker, T. Time patients spend in the emergency department: England’s 4-hour rule—A case of hitting the target but missing the point? Ann. Emerg. Med. 2012, 59, 341–349. [CrossRef] [PubMed]
24. Herring, A.; Wilper, A.; Himmelstein, D.U.; Woolhandler, S.; Espinola, J.A.; Brown, D.F.M.; Camargo Jr, C.A. Increasing length of stay among adult visits to U.S. emergency departments, 2001–2005. Acad. Emerg. Med. 2009, 16, 609–616. [CrossRef] [PubMed]
25. Easter, B.; Houshiarian, N.; Pati, D.; Wiler, J.L. Designing efficient emergency departments: Discrete event simulation of internal-waiting areas and split flow sorting. Am. J. Emerg Med. 2019, 37, 2186–2193. [CrossRef]
26. Fuentes, E.; Shields, J.; Chirumamilla, N.; Martinez, M.; Kaafarani, H.; Yeh, D.D.; White, B.; Filbin, M.; DePesa, C.; Velmahos, G.; et al. “One-way-street” streamlined admission of critically ill trauma patients reduces emergency department length of stay. Intern. Emerg. Med. 2017, 12, 1019–1024. [CrossRef]
27. Ajdari, A.; Boyle, L.N.; Kannan, N.; Wang, J.; Rivara, F.P.; Vavilala, M.S. Simulation of the Emergency Department Care Process for Pediatric Traumatic Brain Injury. J. Healthc. Qual. 2018, 40, 110–118. [CrossRef]
28. Best, A.M.; Dixon, C.A.; Kelton, W.D.; Lindsell, C.J.; Ward, M.J. Using discrete event computer simulation to improve patient flow in a Ghanaian acute care hospital. Am. J. Emerg. Med. 2014, 32, 917–922. [CrossRef]
29. Bokhorst, J.A.C.; van der Vaart, T. Acute medical unit design – The impact of rearranged patient flows. Socio-Econ. Plan. Sci. 2018, 62, 75–83. [CrossRef]
30. Coughlan, J.; Eatock, J.; Patel, N. Simulating the use of re-prioritisation as a wait-reduction strategy in an emergency department. Emerg. Med. J. 2011, 28, 1013–1018. [CrossRef]
31. Gul, M.; Guneri, A.F. A computer simulation model to reduce patient length of stay and to improve resource utilization rate in an emergency department service system. Int. J. Ind. Eng. Theory Appl. Pract. 2012, 19, 221–231.
32. Hung, G.R.; Kissoon, N. Impact of an observation unit and an emergency department-admitted patient transfer mandate in decreasing overcrowding in a pediatric emergency department: A discrete event simulation exercise. Pediatr. Emerg. Care 2009, 25, 160–163. [CrossRef] [PubMed]
33. Ibrahim, I.M.; Liong, C.; Bakar, S.A.; Najmuddin, A.F. Performance improvement of the yellow zone in emergency department using discrete event simulation approach. Int. J. Eng. Technol. 2018, 7, 102–105.
34. Keyloun, K.R.; Lofgren, E.; Hebert, S. Modeling operational quality metrics and costs of long-acting antibiotics for acute bacterial skin and skin structure infection treatment in the emergency department. J. Med. Econ. 2019, 22, 652–661. [CrossRef] [PubMed]
35. Khare, R.K.; Powell, E.S.; Reinhardt, G.; Lucenti, M. Adding More Beds to the Emergency Department or Reducing Admitted Patient Boarding Times: Which Has a More Significant Influence on Emergency Department Congestion? Ann. Emerg. Med. 2009, 53, 575–585. [CrossRef]
36. Konrad, R.; DeSotto, K.; Grocela, A.; McAuley, P.; Wang, J.; Lyons, J.; Bruin, M. Modeling the impact of changing patient flow processes in an emergency department: Insights from a computer simulation study. Oper. Res. Health Care 2013, 2, 66–74. [CrossRef]
37. La, J.; Jewkes, E.M. Defining an optimal ED fast track strategy using simulation. J. Enterp. Inf. Manag. 2013, 26, 109–118. [CrossRef]
38. Baia Medeiros, D.T.; Hahn-Goldberg, S.; Aleman, D.M.; O’Connor, E. Planning Capacity for Mental Health and Addiction Services in the Emergency Department: A Discrete-Event Simulation Approach. J. Healthc. Eng. 2019, 2019, 8973515. [CrossRef]
39. Oh, C.; Novotny, A.M.; Carter, P.L.; Ready, R.K.; Campbell, D.D.; Leckie, M.C. Use of a simulation-based decision support tool to improve emergency department throughput. Oper. Res. Health Care 2016, 9, 29–39. [CrossRef]
40. Paul, J.A.; Lin, L. Models for improving patient throughput and waiting at hospital emergency departments. J. Emerg. Med. 2012, 43, 1119–1126. [CrossRef]
41. Rasheed, F.; Lee, Y.H.; Kim, S.H.; Park, I.C. Development of emergency department load relief area-gauging benefits in empirical terms. Simul. Healthc. 2012, 7, 343–352. [CrossRef]
42. Rosmulder, R.W.; Krabbendam, J.J.; Kerkhoff, A.H.M.; Houser, C.M.; Luitse, J.S.K. Erratum to: Computer SimulationWithinActionResearch: APromisingCombinationforImprovingHealthcareDelivery? ( SystPract Action Res, 10.1007/s11213-011-9191-y). Syst. Pract. Action Res. 2011, 24, 273. [CrossRef]
43. Saoud, M.S.; Boubetra, A.; Attia, S. A simulation knowledge extraction-based decision support system for the healthcare emergency department. Int. J. Healthc. Inf. Syst. Inform. 2016, 11, 19–37. [CrossRef]
44. Steward, D.; Glass, T.F.; Ferrand, Y.B. Simulation-Based Design of ED Operations with Care Streams to Optimize Care Delivery and Reduce Length of Stay in the Emergency Department. J. Med. Syst. 2017, 41, 162. [CrossRef] [PubMed]
45. Thomas Schneider, A.J.; Luuk Besselink, P.; Zonderland, M.E.; Boucherie, R.J.; Van Den Hout, W.B.; Kievit, J.; Bilars, P.; Jaap Fogteloo, A.; Rabelink, T.J. Allocating emergency beds improves the emergency admission flow. Interfaces 2018, 48, 384–394. [CrossRef]
46. Wang, T.; Guinet, A.; Belaidi, A.; Besombes, B. Modelling and simulation of emergency services with ARIS and Arena. case study: The emergency department of Saint Joseph and Saint Luc hospital. Prod. Plan. Control. 2009, 20, 484–495. [CrossRef]
47. Zeng, Z.; Ma, X.; Hu, Y.; Li, J.; Bryant, D. A Simulation Study to Improve Quality of Care in the Emergency Department of a Community Hospital. J. Emerg. Nurs. 2012, 38, 322–328. [CrossRef]
48. Allaudeen, N.; Vashi, A.; Breckenridge, J.S.; Haji-Sheikhi, F.; Wagner, S.; Posley, K.A.; Asch, S.M. Using Lean Management to Reduce Emergency Department Length of Stay for Medicine Admissions. Qual Manag. Health Care 2017, 26, 91–96. [CrossRef]
49. Arbune, A.; Wackerbarth, S.; Allison, P.; Conigliaro, J. Improvement through Small Cycles of Change: Lessons from an Academic Medical Center Emergency Department. J. Healthc. Qual. 2017, 39, 259–269. [CrossRef]
50. Carter, P.M.; Desmond, J.S.; Akanbobnaab, C.; Oteng, R.A.; Rominski, S.D.; Barsan, W.G.; Cunningham, R.M. Optimizing clinical operations as part of a global emergency medicine initiative in Kumasi, Ghana: Application of lean manufacturing principals to low-resource health systems. Acad. Emerg. Med. 2012, 19, 338–347. [CrossRef]
51. Dickson, E.W.; Anguelov, Z.; Bott, P.; Nugent, A.; Walz, D.; Singh, S. The sustainable improvement of patient flow in an emergency treatment centre using Lean. Int. J. Six Sigma Compet. Advant. 2008, 4, 289–304. [CrossRef]
52. Dickson, E.W.; Anguelov, Z.; Vetterick, D.; Eller, A.; Singh, S. Use of Lean in the Emergency Department: A Case Series of 4 Hospitals. Ann. Emerg. Med. 2009, 54, 504–510. [CrossRef] [PubMed]
53. Dickson, E.W.; Singh, S.; Cheung, D.S.; Wyatt, C.C.; Nugent, A.S. Application of Lean Manufacturing Techniques in the Emergency Department. J. Emerg. Med. 2009, 37, 177–182. [CrossRef]
54. Elamir, H. Improving patient flow through applying lean concepts to emergency department. Lead. Health Serv. 2018, 31, 293–309. [CrossRef] [PubMed]
55. Hitti, E.A.; El-Eid, G.R.; Tamim, H.; Saleh, R.; Saliba, M.; Naffaa, L. Improving Emergency Department radiology transportation time: A successful implementation of lean methodology. BMC Health Serv. Res. 2017, 17, 625. [CrossRef] [PubMed]
56. Kane, M.; Chui, K.; Rimicci, J.; Callagy, P.; Hereford, J.; Shen, S.; Norris, R.; Pickham, D. Lean manufacturing improves emergency department throughput and patient satisfaction. J. Nurs. Admin. 2015, 45, 429–434. [CrossRef] [PubMed]
57. Migita, R.; Del Beccaro, M.; Cotter, D.; Woodward, G.A. Emergency department overcrowding: Developing emergency department capacity through process improvement. Clin. Pediatr. Emerg. Med. 2011, 12, 141–150. [CrossRef]
58. Murrell, K.L.; Offerman, S.R.; Kauffman, M.B. Applying Lean: Implementation of a rapid triage and treatment system. West. J. Emerg Med. 2011, 12, 184–191.
59. Ng, D.; Vail, G.; Thomas, S.; Schmidt, N. Applying the Lean principles of the Toyota Production System to reduce wait times in the emergency department. Can. J. Emerg. Med. 2010, 12, 50–57. [CrossRef]
60. Peng, L.S.; Rasid, M.F.; Salim, W.I. Using modified triage system to improve emergency department efficacy: A successful Lean implementation. Int. J. Healthc. Manag. 2019. [CrossRef]
61. Polesello, V.; Dittadi, R.; Afshar, H.; Bassan, G.; Rosada, M.; Ninno, L.D.; Carraro, P. Improving pre-analytical laboratory turnaround time for the emergency department: Outcomes of a pneumatic tube system introduction. Biochim. Clin. 2019, 43, 150–155.
62. Rotteau, L.; Webster, F.; Salkeld, E.; Hellings, C.; Guttmann, A.; Vermeulen, M.J.; Bell, R.S.; Zwarenstein, M.; Rowe,B.H.; Nigam,A.; etal. Ontario’semergency departmentprocess improvementprogram: Theexperience of implementation. Acad. Emerg. Med. 2015, 22, 720–729. [CrossRef] [PubMed]
63. Sánchez, M.; Suárez, M.; Asenjo, M.; Bragulat, E. Improvement of emergency department patient flow using lean thinking. Int. J. Qual. Health Care 2018, 30, 250–256. [CrossRef] [PubMed]
64. Sayed, M.J.E.; El-Eid, G.R.; Saliba, M.; Jabbour, R.; Hitti, E.A. Improving emergency department door to doctor time and process reliability: A successful implementation of lean methodology. Medicine 2015, 94, e1679. [CrossRef] [PubMed]
65. Van Der Linden, M.C.; Van Ufford, H.M.E.; De Beaufort, R.A.Y.; Grauss, R.W.; Hofstee, H.M.A.; Hoogendoorn, J.M.; Meylaerts, S.A.G.; Rijsman, R.M.; De Rooij, T.P.W.; Smith, C.; et al. The impact of a multimodal intervention on emergency department crowding and patient flow. Int. J. Emerg. Med. 2019, 12, 21. [CrossRef]
66. Vermeulen, M.J.; Stukel, T.A.; Guttmann, A.; Rowe, B.H.; Zwarenstein, M.; Golden, B.; Nigam, A.; Anderson, G.; Bell, R.S.; Schull, M.J. Evaluation of an emergency department lean process improvement program to reduce length of stay. Ann. Emerg. Med. 2014, 64, 427–438. [CrossRef]
67. White, B.A.; Chang, Y.; Grabowski, B.G.; Brown, D.F.M. Using lean-based systems engineering to increase capacity in the emergency department. West. J. Emerg. Med. 2014, 15, 770–776. [CrossRef]
68. Cheng, I.; Zwarenstein, M.; Kiss, A.; Castren, M.; Brommels, M.; Schull, M. Factors associated with failure of emergency wait-time targets for high acuity discharges and intensive care unit admissions. Can. J. Emerg. Med. 2018, 20, 112–124. [CrossRef]
69. Forero, R.; Man, N.; McCarthy, S.; Richardson, D.; Mohsin, M.; Toloo, G.S.; FitzGerald, G.; Ngo, H.; Mountain, D.; Fatovich, D.; et al. Impact of the national emergency access target policy on emergency departments’ performance: A time-trend analysis for New South Wales, Australian capital territory and queensland. EMA Emerg. Med. Australas 2019, 31, 253–261. [CrossRef]
70. Kaushik, N.; Khangulov, V.S.; O’hara, M.; Arnaout, R. Reduction in laboratory turnaround time decreases emergency room length of stay. Open Access Emerg. Med. 2018, 10, 37–45. [CrossRef]
71. Maniaci, M.J.; Lachner, C.; Vadeboncoeur, T.F.; Hodge, D.O.; Dawson, N.L.; Rummans, T.A.; Roy, A.; Burton, M.C. Involuntary patient length-of-stay at a suburban emergency department. Am. J. Emerg. Med. 2019. [CrossRef]
72. Singh, N.; Robinson, R.D.; Duane, T.M.; Kirby, J.J.; Lyell, C.; Buca, S.; Gandhi, R.; Mann, S.M.; Zenarosa, N.R.; Wang, H. Role of ED crowding relative to trauma quality care in a Level 1 Trauma Center. Am. J. Emerg. Med. 2019, 37, 579–584. [CrossRef] [PubMed]
73. Street, M.; Mohebbi, M.; Berry, D.; Cross, A.; Considine, J. Influences on emergency department length of stay for older people. Eur. J. Emerg. Med. 2018, 25, 242–249. [CrossRef] [PubMed]
74. Van der Veen, D.; Remeijer, C.; Fogteloo, A.J.; Heringhaus, C.; de Groot, B. Independent determinants of prolonged emergency department length of stay in a tertiary care centre: A prospective cohort study. Scand. J. Trauma Resusc. Emerg. Med. 2018, 26, 81. [CrossRef] [PubMed]
75. Yau, F.F.; Tsai, T.; Lin, Y.; Wu, K.; Syue, Y.; Li, C. Can different physicians providing urgent and non-urgent treatment improve patient flow in emergency department? Am. J. Emerg. Med. 2018, 36, 993–997. [CrossRef] [PubMed]
76. Brent, A.S.; Rahman, W.M.; Knarr, L.L.; Harrison, J.A.; Kearns, K.L.; Lindstrom, D.S. Reducing cycle times in pediatric emergency medicine. Pediatr. Emerg. Care 2009, 25, 307–311. [CrossRef] [PubMed]
77. Fernandes, C.M.B.; Christenson, J.M. Use of continuous quality improvement to facilitate patient flow through the triage and Fast-Track areas of an emergency department. J. Emerg. Med. 1995, 13, 847–855. [CrossRef]
78. Fernandes, C.M.B.; Christenson, J.M.; Price, A. Continuous quality improvement reduces length of stay for fast-track patients in an emergency department. Acad. Emerg. Med. 1996, 3, 258–263. [CrossRef]
79. Higgins, G.L., III; Becker, M.H. A continuous quality improvement approach to IL-372 documentation compliance in an academic emergency department, and its impact on dictation costs, billing practices, and average patient length of stay. Acad. Emerg. Med. 2000, 7, 269–275. [CrossRef]
80. Lovett, P.B.; Illg, M.L.; Sweeney, B.E. A Successful Model for a Comprehensive Patient Flow Management Center at an Academic Health System. Am. J. Med. Qual. 2014, 31, 246–255. [CrossRef]
81. Preyde, M.; Crawford, K.; Mullins, L. Patients’ satisfaction and wait times at Guelph General Hospital Emergency Department before and after implementation of a process improvement project. Can. J. Emerg. Med. 2012, 14, 157–168. [CrossRef]
82. Rehmani, R.; Amatullah, A.F. Quality improvement program in an Emergency Department. Saudi Med. J. 2008, 29, 418–422. [PubMed]
83. Ajmi, F.; Zgaya, H.; Othman, S.B.; Hammadi, S. Agent-based dynamic optimization for managing the workflow of the patient’s pathway. Simul. Model. Pract. Theory 2019, 96, 101935. [CrossRef]
84. Haydar, S.A.; Strout, T.D.; Baumann, M.R. Sustainable Mechanism to Reduce Emergency Department ( ED ) Length of Stay: The Use of ED Holding (ED Transition) Orders to Reduce ED Length of Stay. Acad. Emerg. Med. 2016, 23, 776–785. [CrossRef] [PubMed]
85. Prybutok, G.L. Ninety to Nothing: A PDSA quality improvement project. Int. J. Health Care Qual. Assur. 2018, 31, 361–372. [CrossRef] [PubMed]
86. Oueida, S.; Kotb, Y.; Aloqaily, M.; Jararweh, Y.; Baker, T. An edge computing based smart healthcare framework for resource management. Sensors 2018, 18, 4307. [CrossRef]
87. Derni, O.; Boufera, F.; Khelfi, M.F. Coloured Petri net for modelling and improving emergency department based on the simulation model. Int. J. Simul. Process. Model. 2019, 14, 72–86. [CrossRef]
88. Bellew, S.D.; Collins, S.P.; Barrett, T.W.; Russ, S.E.; Jones, I.D.; Slovis, C.M.; Self, W.H. Implementation of an Opioid Detoxification Management Pathway Reduces Emergency Department Length of Stay. Acad. Emerg. Med. 2018, 25, 1157–1163. [CrossRef]
89. Than, M.P.; Pickering, J.W.; Dryden, J.M.; Lord, S.J.; Aitken, S.A.; Aldous, S.J.; Allan, K.E.; Ardagh, M.W.; Bonning, J.W.N.; Callender, R.; et al. ICare-ACS (Improving Care Processes for Patients with Suspected Acute Coronary Syndrome): A Study of Cross-System Implementation of a National Clinical Pathway. Circulation 2018, 137, 354–363. [CrossRef]
90. Brouns, S.H.A.; Stassen, P.M.; Lambooij, S.L.E.; Dieleman, J.; Vanderfeesten, I.T.P.; Haak, H.R. Organisational factors induce prolonged emergency department length of stay in elderly patients—A retrospective cohort study. PLoS ONE 2015, 10, e135066. [CrossRef]
91. Chan, T.C.; Killeen, J.P.; Kelly, D.; Guss, D.A. Impact of rapid entry and accelerated care at triage on reducing emergency department patient wait times, lengths of stay, and rate of left without being seen. Ann. Emerg. Med. 2005, 46, 491–497. [CrossRef] [PubMed]
92. Christensen, M.; Rosenberg, M.; Mahon, E.; Pineda, S.; Rojas, E.; Soque, V.; Soque, V.; Johansen, M.L. Pivot Nursing: An Alternative to Traditional ED Triage. J. Emerg. Nurs. 2016, 42, 395–399. [CrossRef] [PubMed]
93. Christianson, J.B.; Warrick, L.H.; Howard, R.; Vollum, J. Deploying Six Sigma in a health care system as a work in progress. Jt. Commun. J. Qual. Patient Saf. 2005, 31, 603–613. [CrossRef]
94. DeFlitch, C.; Geeting, G.; Paz, H.L. Reinventing emergency department flow via healthcare delivery science. Health Environ. Res. Des. J. 2015, 8, 105–115. [CrossRef] [PubMed]
95. Liu, Z.; Rexachs, D.; Epelde, F.; Luque, E. An agent-based model for quantitatively analyzing and predicting the complex behavior of emergency departments. J. Comput. Sci. 2017, 21, 11–23. [CrossRef]
96. Oueida, S.; Kotb, Y.; Kadry, S.; Ionescu, S. Healthcare Operation Improvement Based on Simulation of Cooperative Resource Preservation Nets for None-Consumable Resources. Complexity 2018, 2018, 4102968. [CrossRef]
97. Sloan, J.; Chatterjee, K.; Sloan, T.; Holland, G.; Waters, M.; Ewins, D.; Laundy, N. Effect of a pathway bundle on length of stay. Emerg. Med. J. 2009, 26, 479–483. [CrossRef]
98. Stone-Griffith, S.; Englebright, J.D.; Cheung, D.; Korwek, K.M.; Perlin, J.B. Data-driven process and operational improvement in the emergency department: The ED Dashboard and Reporting Application. J. Healthc. Manag. 2012, 57, 167–181. [CrossRef]
99. Bish, P.A.; McCormick, M.A.; Otegbeye, M. Ready-JET-Go: Split Flow Accelerates ED Throughput. J. Emerg. Nurs. 2016, 42, 114–119. [CrossRef]
100. Blick, K.E. Providing critical laboratory results on time, every time to help reduce emergency department length of stay: How our laboratory achieved a six sigma level of performance. Am. J. Clin. Pathol. 2013, 140, 193–202. [CrossRef]
101. Chadha, R.; Singh, A.; Kalra, J. Lean and queuing integration for the transformation of health care processes A lean health care model. Clin. Gov. 2012, 17, 191–199. [CrossRef]
102. Chen, T.; Wang, C. Multi-objective simulation optimization for medical capacity allocation in emergency department. J. Simul. 2016, 10, 50–68. [CrossRef]
103. Elalouf, A.; Wachtel, G. An alternative scheduling approach for improving patient-flow in emergency departments. Oper. Res. Health Care 2015, 7, 94–102. [CrossRef]
104. Feng, Y.; Wu, I.; Chen, T. Stochastic resource allocation in emergency departments with a multi-objective simulation optimization algorithm. Health Care Manag. Sci. 2017, 20, 55–75. [CrossRef]
105. Ferrand, Y.B.; Magazine, M.J.; Rao, U.S.; Glass, T.F. Managing responsiveness in the emergency department: Comparing dynamic priority queue with fast track. J. Oper Manag. 2018, 58–59, 15–26. [CrossRef]
106. Furterer, S.L. Applying Lean Six Sigma methods to reduce length of stay in a hospital’s emergency department. Qual. Eng. 2018, 30, 389–404. [CrossRef]
107. Ghanes, K.; Jouini, O.; Diakogiannis, A.; Wargon, M.; Jemai, Z.; Hellmann, R.; Thomas, V.; Koole, G. Simulation-based optimization of staffing levels in an emergency department. Simulation 2015, 91, 942–953. [CrossRef]
108. Goienetxea Uriarte, A.; Ruiz Zúñiga, E.; Urenda Moris, M.; Ng, A.H.C. How can decision makers be supported in the improvement of an emergency department? A simulation, optimization and data mining approach. Oper. Res. Health Care 2017, 15, 102–122.
109. He, S.; Sim, M.; Zhang, M. Data-driven patient scheduling in emergency departments: A hybrid robust-stochastic approach. Manag. Sci. 2019, 65, 4123–4140. [CrossRef]
110. Huang, D.; Bastani, A.; Anderson, W.; Crabtree, J.; Kleiman, S.; Jones, S. Communication and bed reservation: Decreasing the length of stay for emergency department trauma patients. Am. J. Emerg. Med. 2018, 36, 1874–1879. [CrossRef]
111. Kaner, M.; Gadrich, T.; Dror, S.; Marmor, Y.N. Generating and evaluating simulation scenarios to improve emergency department operations. IIE Trans. Healthc. Syst. Eng. 2014, 4, 156–166. [CrossRef]
112. Lee, E.K.; Atallah, H.Y.; Wright, M.D.; Post, E.T.; Thomas, C.; Wu, D.T.; Haley, L.L. Transforming hospital emergency department workflow and patient care. Interfaces 2015, 45, 58–82. [CrossRef]
113. Lo, M.D.; Rutman, L.E.; Migita, R.T.; Woodward, G.A. Rapid electronic provider documentation design and implementation in an academic pediatric emergency department. Pediatr. Emerg. Care 2015, 31, 798–804. [CrossRef] [PubMed]
114. Oueida, S.; Kotb, Y.; Ionescu, S.; Militaru, G. AMS: A new platform for system design and simulation. Int, J. Simul. Model. 2019, 18, 33–46. [CrossRef]
115. Rachuba, S.; Knapp, K.; Ashton, L.; Pitt, M. Streamlining pathways for minor injuries in emergency departments through radiographer-led discharge. Oper. Res. Health Care 2018, 19, 44–56. [CrossRef]
116. Romano, E.; Guizzi, G.; Chiocca, D. A decision support tool, implemented in a system dynamics model, to improve the effectiveness in the hospital emergency department. Int. J. Procure Manag. 2015, 8, 141–168. [CrossRef]
117. Ross, G.; Johnson, D.; Kobernick, M. Evaluation of a critical pathway for stroke. J. Am. Osteopath Assoc. 1997, 97, 269–276. [CrossRef] [PubMed]
118. Ross, A.J.; Murrells, T.; Kirby, T.; Jaye, P.; Anderson, J.E. An integrated statistical model of Emergency Department length of stay informed by Resilient Health Care principles. Saf. Sci. 2019, 120, 129–136. [CrossRef]
119. Shin, S.Y.; Brun, Y.; Balasubramanian, H.; Henneman, P.L.; Osterweil, L.J. Discrete-Event Simulation and Integer Linear Programming for Constraint-Aware Resource Scheduling. IEEE Trans. Syst. Man Cybern. Syst. 2018, 48, 1578–1593. [CrossRef]
120. Sinreich, D.; Jabali, O. Staggered work shifts: A way to downsize and restructure an emergency department workforce yet maintain current operational performance. Health Care Manag. Sci 2007, 10, 293–308. [CrossRef]
121. Sinreich, D.; Jabali, O.; Dellaert, N.P. Reducing emergency department waiting times by adjusting work shifts considering patient visits to multiple care providers. IIE Trans. 2012, 44, 163–180. [CrossRef]
122. Sir, M.Y.; Nestler, D.; Hellmich, T.; Das, D.; Laughlin, M.J.; Dohlman, M.C.; Pasupathy, K. Optimization of multidisciplinary staffing improves patient experiences at the mayo clinic. Interfaces 2017, 47, 425–441. [CrossRef]
123. Techar, K.; Nguyen, A.; Lorenzo, R.M.; Yang, S.; Thielen, B.; Cain-Nielsen, A.; Hemmila, M.R.; Tignanelli, C.J. Early Imaging Associated With Improved Survival in Older Patients With Mild Traumatic Brain Injuries. J. Surg. Res. 2019, 242, 4–10. [CrossRef]
124. Visintin, F.; Caprara, C.; Puggelli, F. Experimental design and simulation applied to a pediatric emergency department: A case study. Comput. Ind. Eng. 2019, 128, 755–781. [CrossRef]
125. Yousefi, M.; Ferreira, R.P.M. An agent-based simulation combined with group decision-making technique for improving the performance of an emergency department. Braz. J. Med. Biol. Res. 2017, 50. [CrossRef]
126. Yousefi, M.; Yousefi, M.; Ferreira, R.P.M.; Kim, J.H.; Fogliatto, F.S. Chaotic genetic algorithm and Adaboost ensemble metamodeling approach for optimum resource planning in emergency departments. Artif. Intell. Med. 2018, 84, 23–33. [CrossRef]
127. Yousefi, M.; Yousefi, M.; Fogliatto, F.S.; Ferreira, R.P.M.; Kim, J.H. Simulating the behavior of patients who leave a public hospital emergency department without being seen by a physician: A cellular automaton and agent-based framework. Braz. J. Med. Biol. Res. 2018, 51. [CrossRef]
128. Zeltyn, S.; Marmor, Y.N.; Mandelbaum, A.; Carmeli, B.; Greenshpan, O.; Mesika, Y.; Wasserkrug, S.; Vortman, P.; Shtub, A.; Lauterman, T.; et al. Simulation-based models of emergency departments: Operational, tactical, and strategic staffing. ACM Trans. Model. Comput. Simul. 2011, 21, 1–25. [CrossRef]
129. Ashour, O.M.; Okudan Kremer, G.E. A simulation analysis of the impact of FAHP-MAUT triage algorithm on the Emergency Department performance measures. Expert Syst. Appl. 2013, 40, 177–187. [CrossRef]
130. Aroua, A.; Abdulnour, G. Optimization of the emergency department in hospitals using simulation and experimental design: Case study. Procedia Manuf. 2018, 17, 878–885. [CrossRef]
131. Abo-Hamad, W.; Arisha, A. Simulation-based framework to improve patient experience in an emergency department. Eur. J. Oper. Res. 2013, 224, 154–166. [CrossRef]
132. Acuna, J.A.; Zayas-Castro, J.L.; Charkhgard, H. Ambulance allocation optimization model for the overcrowding problem in US emergency departments: A case study in Florida. Socio-Econ. Plan. Sci. 2019. [CrossRef]
133. Ala, A.; Chen, F. Alternative mathematical formulation and hybrid meta-heuristics for patient scheduling problem in health care clinics. Neural Comput. Appl. 2019, in press. [CrossRef]
134. Yousefi, M.; Yousefi, M. Human resource allocation in an emergency department: A metamodel-based simulation optimization. Kybernetes 2019, 49, 779–796. [CrossRef]
135. Duguay, C.; Chetouane, F. Modeling and Improving Emergency Department Systems using Discrete Event Simulation. Simulation 2007, 83, 311–320. [CrossRef]
136. Ibrahim, I.M.; Liong, C.; Bakar, S.A.; Ahmad, N.; Najmuddin, A.F. Estimating optimal resource capacities in emergency department. Indian J. Public Health Res. Dev. 2018, 9, 1558–1565. [CrossRef]
137. Joshi, V.; Lim, C.; Teng, S.G. Simulation Study: Improvement for Non-Urgent Patient Processes in the Emergency Department. EMJ Eng. Manag. J. 2016, 28, 145–157. [CrossRef]
138. Kaushal, A.; Zhao, Y.; Peng, Q.; Strome, T.; Weldon, E.; Zhang, M.; Chochinov, A. Evaluation of fast track strategies using agent-based simulation modeling to reduce waiting time in a hospital emergency department. Socio-Econ. Plan. Sci. 2015, 50, 18–31. [CrossRef]
139. Lamprecht, J.; Kolisch, R.; Pförringer, D. The impact of medical documentation assistants on process performance measures in a surgical emergency department. Eur. J. Med. Res. 2019, 24, 1–8. [CrossRef]
140. Taboada, M.; Cabrera, E.; Epelde, F.; Iglesias, M.L.; Luque, E. Agent-based emergency decision-making aid for hospital emergency departments. Emergencias 2012, 24, 189–195.
141. Wang, J.; Li, J.; Tussey, K.; Ross, K. Reducing length of stay in emergency department: A simulation study at a community hospital. IEEE Trans. Syst. Man Cybern. Part. A Syst. Hum. 2012, 42, 1314–1322. [CrossRef]
142. Yang, K.K.; Lam, S.S.W.; Low, J.M.W.; Ong, M.E.H. Managing emergency department crowding through improved triaging and resource allocation. Oper. Res. Health Care 2016, 10, 13–22. [CrossRef]
143. Hogan, B.; Rasche, C.; Von Reinersdorff, A.B. The First View Concept: Introduction of industrial flow techniques into emergency medicine organization. Eur. J. Emerg. Med. 2012, 19, 136–139. [CrossRef]
144. Ieraci, S.; Digiusto, E.; Sonntag, P.; Dann, L.; Fox, D. Streaming by case complexity: Evaluation of a model for emergency department Fast Track. EMA Emerg. Med. Australas 2008, 20, 241–249. [CrossRef]
145. Improta, G.; Romano, M.; Di Cicco, M.V.; Ferraro, A.; Borrelli, A.; Verdoliva, C.; Triassi, M.; Cesarelli, M. Lean thinking to improve emergency department throughput at AORN Cardarelli hospital. BMC Health Serv. Res. 2018, 18, 914. [CrossRef]
146. Piggott, Z.; Weldon, E.; Strome, T.; Chochinov, A. Application of lean principles to improve early cardiac care in the emergency department. Can. J. Emerg. Med. 2011, 13, 325–332. [CrossRef]
147. Rees, G.H. Organisational readiness and Lean Thinking implementation: Findings from three emergency department case studies in New Zealand. Health Serv. Manag. Res. 2014, 27, 1–9. [CrossRef]
148. Rutman, L.E.; Migita, R.; Woodward, G.A.; Klein, E.J. Creating a leaner pediatric emergency department: How rapid design and testing of a front-end model led to decreased wait time. Pediatr. Emerg. Care 2015, 31, 395–398. [CrossRef]
149. Vashi, A.A.; Sheikhi, F.H.; Nashton, L.A.; Ellman, J.; Rajagopal, P.; Asch, S.M. Applying Lean Principles to Reduce Wait Times in a VA Emergency Department. Mil. Med. 2019, 184, E169–E178. [CrossRef]
150. White, B.A.; Yun, B.J.; Lev, M.H.; Raja, A.S. Applying systems engineering reduces radiology transport cycle times in the emergency department. West. J. Emerg. Med. 2017, 18, 410–418. [CrossRef]
151. Bordoloi, S.K.; Beach, K. Improving operational efficiency in an Inner-city Emergency Department. Health Serv. Manag. Res. 2007, 20, 105–112. [CrossRef]
152. Meng, F.; Teow, K.L.; Ooi, C.K.; Heng, B.H.; Tay, S.Y. Minimization of the coefficient of variation for patient waiting system governed by a generic maximum waiting policy. J. Ind. Manag. Optim. 2017, 13, 1759–1770. [CrossRef]
153. Leo, G.; Lodi, A.; Tubertini, P.; Di Martino, M. Emergency Department Management in Lazio, Italy. Omega 2016, 58, 128–138. [CrossRef]
154. Nezamoddini, N.; Khasawneh, M.T. Modeling and optimization of resources in multi-emergency department settings with patient transfer. Oper. Res. Health Care 2016, 10, 23–34. [CrossRef]
155. Rothwell, S.; McIltrot, K.; Khouri-Stevens, Z. Addressing Emergency Department Issues Using Advanced Practice in Saudi Arabia. J. Nurse Pract. 2018, 14, e41–e44. [CrossRef]
156. Spaite, D.W.; Bartholomeaux, F.; Guisto, J.; Lindberg, E.; Hull, B.; Eyherabide, A.; Lanyon, S.; Criss, E.A.; Valenzuela, T.D.; Conroy, C. Rapid process redesign in a university-based emergency department: Decreasing waiting time intervals and improving patient satisfaction. Ann. Emerg. Med. 2002, 39, 168–177. [CrossRef]
157. Doupe, M.B.; Chateau, D.; Chochinov, A.; Weber, E.; Enns, J.E.; Derksen, S.; Sarkar, J.; Schull, M.; Lobato de Faria, R.; Katz, A.; et al. Comparing the Effect of Throughput and Output Factors on Emergency Department Crowding: A Retrospective Observational Cohort Study. Ann. Emerg. Med. 2018, 72, 410–419. [CrossRef]
158. Eiset, A.H.; Kirkegaard, H.; Erlandsen, M. Crowding in the emergency department in the absence of boarding—A transition regression model to predict departures and waiting time. BMC Med. Res. Methodol. 2019, 19, 68. [CrossRef]
159. Cookson, D.; Read, C.; Mukherjee, P.; Cooke, M. Improving the quality of Emergency Department care by removing waste using Lean Value Stream mapping. Int. J. Clin. Lead. 2011, 17, 25–30.
160. Fulbrook, P.; Jessup, M.; Kinnear, F. Implementation and evaluation of a ‘Navigator’ role to improve emergency department throughput. Australas Emerg. Nurs. J. 2017, 20, 114–121. [CrossRef]
161. Popovich, M.A.; Boyd, C.; Dachenhaus, T.; Kusler, D. Improving Stable Patient Flow through the Emergency Department by Utilizing Evidence-Based Practice: One Hospital’s Journey. J. Emerg. Nurs. 2012, 38, 474–478. [CrossRef]
162. Aminuddin, W.M.W.M.; Ismail, W.R.; Harunarashid, H. Resources improvement in emergency department using simulation and data envelopment analysis. Sains Malays. 2018, 47, 2231–2240.
163. Andersen, A.R.; Nielsen, B.F.; Reinhardt, L.B.; Stidsen, T.R. Staff optimization for time-dependent acute patient flow. Eur. J. Oper. Res. 2019, 272, 94–105. [CrossRef]
164. Zhao, Y.; Peng, Q.; Strome, T.; Weldon, E.; Zhang, M.; Chochinov, A. Bottleneck detection for improvement of emergency department efficiency. Bus. Process. Manag. J. 2015, 21, 564–585. [CrossRef]
165. Azadeh, A.; Hosseinabadi Farahani, M.; Torabzadeh, S.; Baghersad, M. Scheduling prioritized patients in emergency department laboratories. Comput. Methods Programs Biomed. 2014, 117, 61–70. [CrossRef]
166. Bal, A.; Ceylan, C.; Taçog˘lu, C. Using value stream mapping and discrete event simulation to improve efficiency of emergency departments. Int. J. Healthc. Manag. 2017, 10, 196–206. [CrossRef]
167. Benson, R.; Harp, N. Using systems thinking to extend continuous quality improvement. Qual. Lett. Healthc. Lead. 1994, 6, 17–24.
168. Daldoul, D.; Nouaouri, I.; Bouchriha, H.; Allaoui, H. A stochastic model to minimize patient waiting time in an emergency department. Oper. Res. Health Care 2018, 18, 16–25. [CrossRef]
169. Diefenbach, M.; Kozan, E. Effects of bed configurations at a hospital emergency department. J. Simul. 2011, 5, 44–57. [CrossRef]
170. EL-Rifai, O.; Garaix, T.; Augusto, V.; Xie, X. A stochastic optimization model for shift scheduling in emergency departments. Health Care Manag. Sci. 2015, 18, 289–302. [CrossRef]
171. Gartner, D.; Padman, R.Machine learning for healthcare behaviouralOR: Addressing waitingtime perceptions in emergency care. J. Oper. Res. Soc. 2019. [CrossRef]
172. González, J.; Ferrer, J.; Cataldo, A.; Rojas, L. A proactive transfer policy for critical patient flow management. Health Care Manag. Sci. 2019, 22, 287–303. [CrossRef]
173. Izady, N.; Worthington, D. Setting staffing requirements for time dependent queueing networks: The case of accident and emergency departments. Eur. J. Oper. Res. 2012, 219, 531–540. [CrossRef]
174. Kuo, Y.H. Integrating simulation with simulated annealing for scheduling physicians in an understaffed emergency department. Hong Kong Inst. Eng. Trans. 2014, 21, 253–261. [CrossRef]
175. Lau, H.; Dadich, A.; Nakandala, D.; Evans, H.; Zhao, L. Development of a cost-optimization model to reduce bottlenecks: A health service case study. Expert Syst. 2018, 35, e12294. [CrossRef]
176. Martínez, P.; Martínez, J.; Nuño, P.; Cavazos, J. Improvement of patient care time in an emergency department through the application of lean manufacturing. Inf. Tecnol. 2015, 26, 187–198. [CrossRef]
177. Mazzocato, P.; Holden, R.J.; Brommels, M.; Aronsson, H.; Bäckman, U.; Elg, M.; Thor, J. How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children’s hospital, Stockholm, Sweden. BMC Health Serv. Res. 2012, 12, 28. [CrossRef]
178. Ben Othman, S.; Zgaya, H.; Hammadi, S.; Quilliot, A.; Martinot, A.; Renard, J. Agents endowed with uncertainty management behaviors to solve a multiskill healthcare task scheduling. J. Biomed. Inform. 2016, 64, 25–43. [CrossRef]
179. Ben Othman, S.; Hammadi, S. A multi-criteria optimization approach to health care tasks scheduling under resources constraints. Int. J. Comput. Intell. Syst. 2017, 10, 419–439. [CrossRef]
180. Perry, A. Code Critical: Improving Care Delivery for Critically Ill Patients in the Emergency Department. J. Emerg. Nurs. 2019, 46, 199–204. [CrossRef]
181. Stephens, A.S.; Broome, R.A. Impact of emergency department occupancy on waiting times, rates of admission and representation, and length of stay when hospitalised: A data linkage study. EMA Emerg. Med. Australas 2019, 31, 555–561. [CrossRef]
182. Umble, M.; Umble, E.J. Utilizing buffer management to improve performance in a healthcare environment. Eur. J. Oper. Res. 2006, 174, 1060–1075. [CrossRef]
183. Xu, K.; Chan, C.W. Using future information to reduce waiting times in the emergency department via diversion. Manuf. Serv. Oper. Manag. 2016, 18, 314–331. [CrossRef]
184. Zeinali, F.; Mahootchi, M.; Sepehri, M.M. Resource planning in the emergency departments: A simulation-based metamodeling approach. Simul. Model. Pract. Theory 2015, 53, 123–138. [CrossRef]
185. Ahalt, V.; Argon, N.T.; Ziya, S.; Strickler, J.; Mehrotra, A. Comparison of emergency department crowding scores: A discrete-event simulation approach. Health Care Manag. Sci. 2018, 21, 144–155. [CrossRef]
186. Fitzgerald, J.A.; Eljiz, K.; Dadich, A.; Sloan, T.; Hayes, K.J. Health services innovation: Evaluating process changes to improve patient flow. Int. J. Healthc. Technol. Manag. 2011, 12, 280–292. [CrossRef]
187. Peck, J.S.; Benneyan, J.C.; Nightingale, D.J.; Gaehde, S.A. Characterizing the value of predictive analytics in facilitating hospital patient flow. IIE Trans. Healthc. Syst. Eng. 2014, 4, 135–143. [CrossRef]
188. Restrepo-Zea, J.H.; Jaén-Posada, J.S.; Piedrahita, J.J.E.; Flórez, P.A.Z. Emergency department overcrowding: A four-hospital analysis in Medellín and a strategy simulation. Rev. Gerenc. Polit. Salud 2018, 17, 130–144.
189. Aaronson, E.; Mort, E.; Soghoian, S. Mapping the process of emergency care at a teaching hospital in Ghana. Healthcare 2017, 5, 214–220. [CrossRef]
190. Al Owad, A.; Samaranayake, P.; Karim, A.; Ahsan, K.B. An integrated lean methodology for improving patient flow in an emergency department–case study of a Saudi Arabian hospital. Prod. Plan. Control 2018, 29, 1058–1081. [CrossRef]
191. Vose, C.; Reichard, C.; Pool, S.; Snyder, M.; Burmeister, D. Using LEAN to improve a segment of emergency department flow. J. Nurs. Admin. 2014, 44, 558–563. [CrossRef]
192. Hu, B.; Wang, Z.; Wang, S.; He, L.; Wu, J.; Wang, F.; Zhu, X.; Gu, S. Key factors affecting the correlation between improving work efficiency and emergency department overcrowding in the tertiary level A hospitals. Chin. J. Emerg. Med. 2018, 27, 943–948.
193. Wang, X. Emergency department staffing: A separated continuous linear programming approach. Math. Probl. Eng. 2013, 2013, 680152. [CrossRef]
194. Aldarrab, A. Application of Lean Six Sigma for patients presenting with ST-elevation myocardial infarction: The Hamilton Health Sciences experience. Healthc. Q. 2006, 9, 56–61. [CrossRef]
195. Beck, M.J.; Okerblom, D.; Kumar, A.; Bandyopadhyay, S.; Scalzi, L.V. Lean intervention improves patient discharge times, improves emergency department throughput and reduces congestion. Hosp. Pract. 2016, 44, 252–259. [CrossRef]
196. El-Rifai, O.; Garaix, T.; Xie, X. Proactive on-call scheduling during a seasonal epidemic. Oper. Res. Health Care 2016, 8, 53–61. [CrossRef]
197. Garrett, J.S.; Berry, C.; Wong, H.; Qin, H.; Kline, J.A. The effect of vertical split-flow patient management on emergency department throughput and efficiency. Am. J. Emerg. Med. 2018, 36, 1581–1584. [CrossRef]
198. Hussein, N.A.; Abdelmaguid, T.F.; Tawfik, B.S.; Ahmed, N.G.S. Mitigating overcrowding in emergency departments using Six Sigma and simulation: A case study in Egypt. Oper. Res. Health Care 2017, 15, 1–12. [CrossRef]
199. Landa, P.; Sonnessa, M.; Tànfani, E.; Testi, A. Multiobjective bed management considering emergency and elective patient flows. Int. Trans. Oper. Res. 2018, 25, 91–110. [CrossRef]
200. Peltan, I.D.; Bledsoe, J.R.; Oniki, T.A.; Sorensen, J.; Jephson, A.R.; Allen, T.L.; Samore, M.H.; Hough, C.L.; Brown, S.M. Emergency Department Crowding Is Associated With Delayed Antibiotics for Sepsis. Ann. Emerg. Med. 2019, 73, 345–355. [CrossRef]
201. Khanna, S.; Sier, D.; Boyle, J.; Zeitz, K. Discharge timeliness and its impact on hospital crowding and emergency department flow performance. EMA Emerg. Med. Australas 2016, 28, 164–170. [CrossRef]
202. Vile, J.L.; Allkins, E.; Frankish, J.; Garland, S.; Mizen, P.; Williams, J.E. Modelling patient flow in an emergency department to better understand demand management strategies. J. Simul. 2017, 11, 115–127. [CrossRef]
203. Matt, D.T.; Arcidiacono, G.; Rauch, E. Applying lean to healthcare delivery processes—A case-based. Int. J. Adv. Sci. Eng. Inf. Technol. 2018, 8, 123–133. [CrossRef]
204. Goldmann, D.A.; Saul, C.A.; Parsons, S.; Mansoor, C.; Abbott, A.; Damian, F.; Young, G.J.; Homer, C.; Caputo, G.L. Hospital-based continuous quality improvement: A realistic appraisal. Clin. Perform. Qual. Health Care 1993, 1, 69–80.
205. Henderson, D.; Dempsey, C.; Larson, K.; Appleby, D. The impact of IMPACT on St. John’s Regional Health Center. Mo. Med. 2003, 100, 590–592.
206. Jackson, G.; Andrew, J. Using a multidisciplinary CQI approach to reduce ER-to-floor admission time. J. Healthc. Qual. 1996, 18, 18–21. [CrossRef]
207. Markel, K.N.; Marion, S.A. CQI: Improving the time to thrombolytic therapy for patients with acute myocardial infarction in the emergency department. J. Emerg. Med. 1996, 14, 685–689. [CrossRef]
208. Courtad, B.; Baker, K.; Magazine, M.; Polak, G. Minimizing flowtime for paired tasks. Eur. J. Oper. Res. 2017, 259, 818–828. [CrossRef]
209. Iyer, S.; Reeves, S.; Varadarajan, K.; Alessandrini, E. The acute care model: A new framework for quality care in emergency medicine. Clin. Pediatr. Emerg. Med. 2011, 12, 91–101. [CrossRef]
210. Mohan, S.; Nandi, D.; Stephens, P.; M’Farrej, M.; Vogel, R.L.; Bonafide, C.P. Implementation of a clinical pathway for chest pain in a pediatric emergency department. Pediatr. Emerg. Care 2018, 34, 778–782. [CrossRef]
211. Ollivere, B.; Rollins, K.; Brankin, R.; Wood, M.; Brammar, T.J.; Wimhurst, J. Optimising fast track care for proximal femoral fracture patients using modified early warning score. Ann. R. Coll. Surg. Engl. 2012, 94, e267–e271. [CrossRef]
212. Azadeh, A.; Rouhollah, F.; Davoudpour, F.; Mohammadfam, I. Fuzzy modelling and simulation of an emergency department for improvement of nursing schedules with noisy and uncertain inputs. Int. J. Serv. Oper. Manag. 2013, 15, 58–77. [CrossRef]
213. Brenner, S.; Zeng, Z.; Liu, Y.; Wang, J.; Li, J.; Howard, P.K. Modeling and analysis of the emergency department at university of Kentucky Chandler Hospital using simulations. J. Emerg. Nurs. 2010, 36, 303–310. [CrossRef]
214. Guo, H.; Gao, S.; Tsui, K.; Niu, T. Simulation Optimization for Medical Staff Configuration at Emergency Department in Hong Kong. IEEE Trans. Autom. Sci. Eng. 2017, 14, 1655–1665. [CrossRef]
215. Hajjarsaraei, H.; Shirazi, B.; Rezaeian, J. Scenario-based analysis of fast track strategy optimization on emergency department using integrated safety simulation. Saf. Sci. 2018, 107, 9–21. [CrossRef]
216. Huang,Y.; Klassen,K.J.Usingsixsigma, lean, andsimulationtoimprovethephlebotomyprocess. Qual.Manag. J. 2016, 23, 6–21. [CrossRef]
217. Keeling, K.B.; Brown, E.; Kros, J.F. Using process capability analysis and simulation to improve patient flow. Appl. Manag. Sci. 2013, 16, 219–229.
218. Ryan, A.; Hunter, K.; Cunningham, K.; Williams, J.; O’Shea, H.; Rooney, P.; Hickey, F. STEPS: Lean thinking, theory of constraints and identifying bottlenecks in an emergency department. Ir. Med. J. 2013, 106, 105–107.
219. Shirazi, B. Fast track system optimization of emergency departments: Insights from a computer simulation study. Int. J. Model. Simul. Sci. Comput. 2016, 7, 1650015. [CrossRef]
220. Stanton, P.; Gough, R.; Ballardie, R.; Bartram, T.; Bamber, G.J.; Sohal, A. Implementing lean management/Six Sigma in hospitals: Beyond empowerment or work intensification? Int. J. Hum. Resour. Manag. 2014, 25, 2926–2940. [CrossRef]
221. Weimann, E. Lean management and continuous improvement process in hospitals. Pneumologe 2018, 15, 202–208. [CrossRef]
222. Hitti, E.; Hadid, D.; Tamim, H.; Al Hariri, M.; El Sayed, M. Left without being seen in a hybrid point of service collection model emergency department. Am. J. Emerg. Med. 2019. [CrossRef]
223. Jiang, S.; Chin, K.; Tsui, K.L. A universal deep learning approach for modeling the flow of patients under different severities. Comput. Methods Programs Biomed. 2018, 154, 191–203. [CrossRef]
224. Welch, S.J.; Allen, T.L. Data-driven quality improvement in the Emergency Department at a level one trauma and tertiary care hospital. J. Emerg. Med. 2006, 30, 269–276. [CrossRef]
225. Schwab, R.A.; DelSorbo, S.M.; Cunningham, M.R.; Craven, K.; Watson, W.A. Using statistical process control to demonstrate the effect of operational interventions on quality indicators in the emergency department. J. Healthc. Qual. 1999, 21, 38–41. [CrossRef]
226. Nuñez-Perez, N.; Ortíz-Barrios, M.; McClean, S.; Salas-Navarro, K.; Jimenez-Delgado, G.; Castillo-Zea, A. Discrete-event simulation to reduce waiting time in accident and emergency departments: A case study in a district general clinic. In Lecture Notes in Computer Science; 10586 LNCS:352-363; Springer: Cham, Switzerland, 2017.
227. Troncoso-Palacio, A.; Neira-Rodado, D.; Ortíz-Barrios, M.; Jiménez-Delgado, G.; Hernández-Palma, H. Using discrete-event-simulation for improving operational efficiency in laboratories: A case study in pharmaceutical industry. In Lecture Notes in Computer Science; 10942 LNCS:440-451; Springer: Cham, Switzerland, 2018.
228. Ortiz-Barrios, M.; Pancardo, P.; Jiménez-Delgado, G.; De Ávila-Villalobos, J. Applying Multi-phase DES Approach for Modelling the Patient Journey Through Accident and Emergency Departments. In Lecture Notes in Computer Science; 11582 LNCS:87-100; Springer: Cham, Switzerland, 2019.
229. Ortiz, M.A.; McClean, S.; Nugent, C.D.; Castillo, A. Reducing appointment lead-time in an outpatient department of gynecology and obstetrics through discrete-event simulation: A case study. In Lecture Notes in Computer Science; 10069 LNCS:274-285; Springer: Cham, Switzerland, 2016.
230. World Health Organization (WHO); Organisation for Economic Co-operation and Development ( OECD); World Bank Group. Delivering Quality Health Services: A Global Imperative for Universal Health Coverage; Licence: CC BY-NC-SA 3.0 IGO; World Health Organization, Organisation for Economic Co-operation and Development, and The World Bank: Geneva, Switzerland, 2018.
dc.rights.spa.fl_str_mv CC0 1.0 Universal
dc.rights.uri.spa.fl_str_mv http://creativecommons.org/publicdomain/zero/1.0/
dc.rights.accessrights.spa.fl_str_mv info:eu-repo/semantics/openAccess
dc.rights.coar.spa.fl_str_mv http://purl.org/coar/access_right/c_abf2
rights_invalid_str_mv CC0 1.0 Universal
http://creativecommons.org/publicdomain/zero/1.0/
http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv openAccess
dc.publisher.spa.fl_str_mv International Journal of Environmental Research and Public Health
institution Corporación Universidad de la Costa
bitstream.url.fl_str_mv https://repositorio.cuc.edu.co/bitstreams/4272a193-b16e-4233-a6b0-9d027c236624/download
https://repositorio.cuc.edu.co/bitstreams/71140406-5204-4e5e-869a-e55501c89c95/download
https://repositorio.cuc.edu.co/bitstreams/fed4e31d-dcc1-41f7-9ca6-954406aa841e/download
https://repositorio.cuc.edu.co/bitstreams/1fa61cb8-68bc-4041-9bf9-79dbd978a6b5/download
https://repositorio.cuc.edu.co/bitstreams/8be919b4-3848-4711-b8da-f94b169b512a/download
https://repositorio.cuc.edu.co/bitstreams/7656ac79-c7fc-47ff-b224-7c05ad72f442/download
bitstream.checksum.fl_str_mv c8da5e392c5e14f1444093b61bc30430
42fd4ad1e89814f5e4a476b409eb708c
8a4605be74aa9ea9d79846c1fba20a33
026e617f6fe12837e1088b0bec3e1145
026e617f6fe12837e1088b0bec3e1145
67280d1fbda686c5c06c46dd0477bf51
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
MD5
MD5
MD5
repository.name.fl_str_mv Repositorio de la Universidad de la Costa CUC
repository.mail.fl_str_mv repdigital@cuc.edu.co
_version_ 1811760841134964736
spelling Ortiz Barrios, Miguel AngelAlfaro-Saíz, Juan-José2020-04-29T20:47:40Z2020-04-29T20:47:40Z2020-04-031661-78271660-4601https://hdl.handle.net/11323/6244https://doi.org/10.3390/ijerph17082664Corporación Universidad de la CostaREDICUC - Repositorio CUChttps://repositorio.cuc.edu.co/The most commonly used techniques for addressing each Emergency Department (ED) problem (overcrowding, prolonged waiting time, extended length of stay, excessive patient flow time, and high left-without-being-seen (LWBS) rates) were specified to provide healthcare managers and researchers with a useful framework for effectively solving these operational deficiencies. Finally, we identified the existing research tendencies and highlighted opportunities for future work. We implemented the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology to undertake a review including scholarly articles published between April 1993 and October 2019. The selected papers were categorized considering the leading ED problems and publication year. Two hundred and three (203) papers distributed in 120 journals were found to meet the inclusion criteria. Furthermore, computer simulation and lean manufacturing were concluded to be the most prominent approaches for addressing the leading operational problems in EDs. In future interventions, ED administrators and researchers are widely advised to combine Operations Research (OR) methods, quality-based techniques, and data-driven approaches for upgrading the performance of EDs. On a different tack, more interventions are required for tackling overcrowding and high left-without-being-seen ratesOrtiz Barrios, Miguel Angel-will be generated-orcid-0000-0001-6890-7547-600Alfaro-Saíz, Juan-JoséengInternational Journal of Environmental Research and Public HealthCC0 1.0 Universalhttp://creativecommons.org/publicdomain/zero/1.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2HealthcareEmergency departmentProcess improvementSystematic reviewMethodological approaches to support process improvement in emergency departments: a systematic reviewArtículo de revistahttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_2df8fbb1Textinfo:eu-repo/semantics/articlehttp://purl.org/redcol/resource_type/ARTinfo:eu-repo/semantics/acceptedVersion1. Soril, L.J.J.; Leggett, L.E.; Lorenzetti, D.L.; Noseworthy, T.W.; Clement, F.M. Reducing frequent visits to the emergency department:A systematic review of interventions. PLoS ONE 2015, 10, e0123660. [CrossRef] [PubMed]2. Jarvis, P.R.E. Improving emergency department patient flow. Clin. Exp. Emerg. Med. 2016, 3, 63. [CrossRef] [PubMed]3. Emergency Department Quality Improvement: Transforming the Delivery of Care. Available online: https://www.healthcatalyst.com/insights/emergency-department-quality-improvement-transformingdelivery-care (accessed on 20 March 2020).4. Migita, R.; Yoshida, H.; Rutman, L.; Woodward, G.A. Quality Improvement Methodologies: Principles and Applications in the Pediatric Emergency Department. Pediatr. Clin. N. Am. 2018, 65, 1283–1296. [CrossRef] [PubMed]5. Holden, R.J. Lean thinking in emergency departments: A critical review. Ann. Emerg. Med. 2011, 57, 265–278. [CrossRef] [PubMed]6. Mazzocato, P.; Savage, C.; Brommels, M.; Aronsson, H.; Thor, J. Lean thinking in healthcare: A realist review of the literature. Qual. Saf. Health Care 2010, 19, 376–382. [CrossRef]7. Günal, M.M.; Pidd, M. Discrete event simulation for performance modelling in health care: A review of the literature. J. Simul. 2010, 4, 42–51. [CrossRef]8. Paul, S.A.; Reddy, M.C.; Deflitch, C.J. A systematic review of simulation studies investigating emergency department overcrowding. Simulation 2010, 86, 559–571. [CrossRef]9. Vanbrabant, L.; Braekers, K.; Ramaekers, K.; Van Nieuwenhuyse, I. Simulation of emergency department operations: A comprehensive review of KPIs and operational improvements. Comput. Ind. Eng. 2019, 131, 356–381. [CrossRef]10. Saghafian, S.; Austin, G.; Traub, S.J. Operations research/management contributions to emergency department patient flow optimization: Review and research prospects. IIE Trans. Healthc. Syst. Eng. 2015, 5, 101–123. [CrossRef]11. Althaus, F.; Paroz, S.; Hugli, O.; Ghali, W.A.; Daeppen, J.; Peytremann-Bridevaux, I.; Bodenmann, P. Effectiveness of interventions targeting frequent users of emergency departments: A systematic review. Ann. Emerg. Med. 2011, 58, 41–52. [CrossRef]12. Flores-Mateo, G.; Violan-Fors, C.; Carrillo-Santisteve, P.; Peiró, S.; Argimon, J. Effectiveness of organizational interventions to reduce emergency department utilization: A systematic review. PLoS ONE 2012, 7, 1 – 7. [CrossRef] [PubMed]13. Boyle, A.; Beniuk, K.; Higginson, I.; Atkinson, P. Emergency Department Crowding: Time for Interventions and Policy Evaluations. Emerg. Med. Int. 2012, 2012, 1–8. [CrossRef] [PubMed]14. Crawford, K.; Morphet, J.; Jones, T.; Innes, K.; Griffiths, D.; Williams, A. Initiatives to reduce overcrowding and access block in Australian emergency departments: A literature review. Collegian 2014, 21, 359–366. [CrossRef] [PubMed]15. Uscher-Pines, L.; Pines, J.; Kellermann, A.; Gillen, E.; Mehrotra, A. Deciding to Visit the Emergency Departement for Non-Urgent Conditions: A Systematic Review of the Literature. Am. J. Manag. Care 2013, 19, 47.16. Oredsson, S.; Jonsson, H.; Rognes, J.; Lind, L.; Göransson, K.E.; Ehrenberg, A.; Asplund, K.; Castrén, M.; Farrohknia, N. A systematic review of triage-related interventions to improve patient flow in emergency departments. Scand. J. Trauma Resusc. Emerg. Med. 2011, 19. [CrossRef]17. Clarey, A.J.; Cooke, M.W. Patients who leave emergency departments without being seen: Literature review and English data analysis. Emerg. Med. J. 2012, 29, 617–621. [CrossRef]18. Marcozzi, D.; Carr, B.; Liferidge, A.; Baehr, N.; Browne, B. Trends in the Contribution of Emergency Departments to the Provision of Hospital-Associated Health Care in the USA. Int. J. Health Serv. 2018, 48, 267–288. [CrossRef]19. Bellow, A.A.; Gillespie, G.L. The evolution of ED crowding. J. Emerg. Nurs. 2014, 40, 153–160. [CrossRef]20. Ashour, O.M.; Okudan Kremer, G.E. Dynamic patient grouping and prioritization: A new approach to emergency department flow improvement. Health Care Manag. Sci. 2016, 19, 192–205. [CrossRef]21. Tiwari, Y.; Goel, S.; Singh, A. Arrival time pattern and waiting time distribution of patients in the emergency outpatient department of a tertiary level health care institution of North India. J. Emerg. Trauma Shock 2014, 7, 160–165.22. Driesen, B.E.J.M.; Van Riet, B.H.G.; Verkerk, L.; Bonjer, H.J.; Merten, H.; Nanayakkara, P.W.B. Long length of stay at the emergency department is mostly caused by organisational factors outside the influence of the emergency department: A root cause analysis. PLoS ONE 2018, 13, 1–15. [CrossRef] [PubMed]23. Mason, S.; Weber, E.J.; Coster, J.; Freeman, J.; Locker, T. Time patients spend in the emergency department: England’s 4-hour rule—A case of hitting the target but missing the point? Ann. Emerg. Med. 2012, 59, 341–349. [CrossRef] [PubMed]24. Herring, A.; Wilper, A.; Himmelstein, D.U.; Woolhandler, S.; Espinola, J.A.; Brown, D.F.M.; Camargo Jr, C.A. Increasing length of stay among adult visits to U.S. emergency departments, 2001–2005. Acad. Emerg. Med. 2009, 16, 609–616. [CrossRef] [PubMed]25. Easter, B.; Houshiarian, N.; Pati, D.; Wiler, J.L. Designing efficient emergency departments: Discrete event simulation of internal-waiting areas and split flow sorting. Am. J. Emerg Med. 2019, 37, 2186–2193. [CrossRef]26. Fuentes, E.; Shields, J.; Chirumamilla, N.; Martinez, M.; Kaafarani, H.; Yeh, D.D.; White, B.; Filbin, M.; DePesa, C.; Velmahos, G.; et al. “One-way-street” streamlined admission of critically ill trauma patients reduces emergency department length of stay. Intern. Emerg. Med. 2017, 12, 1019–1024. [CrossRef]27. Ajdari, A.; Boyle, L.N.; Kannan, N.; Wang, J.; Rivara, F.P.; Vavilala, M.S. Simulation of the Emergency Department Care Process for Pediatric Traumatic Brain Injury. J. Healthc. Qual. 2018, 40, 110–118. [CrossRef]28. Best, A.M.; Dixon, C.A.; Kelton, W.D.; Lindsell, C.J.; Ward, M.J. Using discrete event computer simulation to improve patient flow in a Ghanaian acute care hospital. Am. J. Emerg. Med. 2014, 32, 917–922. [CrossRef]29. Bokhorst, J.A.C.; van der Vaart, T. Acute medical unit design – The impact of rearranged patient flows. Socio-Econ. Plan. Sci. 2018, 62, 75–83. [CrossRef]30. Coughlan, J.; Eatock, J.; Patel, N. Simulating the use of re-prioritisation as a wait-reduction strategy in an emergency department. Emerg. Med. J. 2011, 28, 1013–1018. [CrossRef]31. Gul, M.; Guneri, A.F. A computer simulation model to reduce patient length of stay and to improve resource utilization rate in an emergency department service system. Int. J. Ind. Eng. Theory Appl. Pract. 2012, 19, 221–231.32. Hung, G.R.; Kissoon, N. Impact of an observation unit and an emergency department-admitted patient transfer mandate in decreasing overcrowding in a pediatric emergency department: A discrete event simulation exercise. Pediatr. Emerg. Care 2009, 25, 160–163. [CrossRef] [PubMed]33. Ibrahim, I.M.; Liong, C.; Bakar, S.A.; Najmuddin, A.F. Performance improvement of the yellow zone in emergency department using discrete event simulation approach. Int. J. Eng. Technol. 2018, 7, 102–105.34. Keyloun, K.R.; Lofgren, E.; Hebert, S. Modeling operational quality metrics and costs of long-acting antibiotics for acute bacterial skin and skin structure infection treatment in the emergency department. J. Med. Econ. 2019, 22, 652–661. [CrossRef] [PubMed]35. Khare, R.K.; Powell, E.S.; Reinhardt, G.; Lucenti, M. Adding More Beds to the Emergency Department or Reducing Admitted Patient Boarding Times: Which Has a More Significant Influence on Emergency Department Congestion? Ann. Emerg. Med. 2009, 53, 575–585. [CrossRef]36. Konrad, R.; DeSotto, K.; Grocela, A.; McAuley, P.; Wang, J.; Lyons, J.; Bruin, M. Modeling the impact of changing patient flow processes in an emergency department: Insights from a computer simulation study. Oper. Res. Health Care 2013, 2, 66–74. [CrossRef]37. La, J.; Jewkes, E.M. Defining an optimal ED fast track strategy using simulation. J. Enterp. Inf. Manag. 2013, 26, 109–118. [CrossRef]38. Baia Medeiros, D.T.; Hahn-Goldberg, S.; Aleman, D.M.; O’Connor, E. Planning Capacity for Mental Health and Addiction Services in the Emergency Department: A Discrete-Event Simulation Approach. J. Healthc. Eng. 2019, 2019, 8973515. [CrossRef]39. Oh, C.; Novotny, A.M.; Carter, P.L.; Ready, R.K.; Campbell, D.D.; Leckie, M.C. Use of a simulation-based decision support tool to improve emergency department throughput. Oper. Res. Health Care 2016, 9, 29–39. [CrossRef]40. Paul, J.A.; Lin, L. Models for improving patient throughput and waiting at hospital emergency departments. J. Emerg. Med. 2012, 43, 1119–1126. [CrossRef]41. Rasheed, F.; Lee, Y.H.; Kim, S.H.; Park, I.C. Development of emergency department load relief area-gauging benefits in empirical terms. Simul. Healthc. 2012, 7, 343–352. [CrossRef]42. Rosmulder, R.W.; Krabbendam, J.J.; Kerkhoff, A.H.M.; Houser, C.M.; Luitse, J.S.K. Erratum to: Computer SimulationWithinActionResearch: APromisingCombinationforImprovingHealthcareDelivery? ( SystPract Action Res, 10.1007/s11213-011-9191-y). Syst. Pract. Action Res. 2011, 24, 273. [CrossRef]43. Saoud, M.S.; Boubetra, A.; Attia, S. A simulation knowledge extraction-based decision support system for the healthcare emergency department. Int. J. Healthc. Inf. Syst. Inform. 2016, 11, 19–37. [CrossRef]44. Steward, D.; Glass, T.F.; Ferrand, Y.B. Simulation-Based Design of ED Operations with Care Streams to Optimize Care Delivery and Reduce Length of Stay in the Emergency Department. J. Med. Syst. 2017, 41, 162. [CrossRef] [PubMed]45. Thomas Schneider, A.J.; Luuk Besselink, P.; Zonderland, M.E.; Boucherie, R.J.; Van Den Hout, W.B.; Kievit, J.; Bilars, P.; Jaap Fogteloo, A.; Rabelink, T.J. Allocating emergency beds improves the emergency admission flow. Interfaces 2018, 48, 384–394. [CrossRef]46. Wang, T.; Guinet, A.; Belaidi, A.; Besombes, B. Modelling and simulation of emergency services with ARIS and Arena. case study: The emergency department of Saint Joseph and Saint Luc hospital. Prod. Plan. Control. 2009, 20, 484–495. [CrossRef]47. Zeng, Z.; Ma, X.; Hu, Y.; Li, J.; Bryant, D. A Simulation Study to Improve Quality of Care in the Emergency Department of a Community Hospital. J. Emerg. Nurs. 2012, 38, 322–328. [CrossRef]48. Allaudeen, N.; Vashi, A.; Breckenridge, J.S.; Haji-Sheikhi, F.; Wagner, S.; Posley, K.A.; Asch, S.M. Using Lean Management to Reduce Emergency Department Length of Stay for Medicine Admissions. Qual Manag. Health Care 2017, 26, 91–96. [CrossRef]49. Arbune, A.; Wackerbarth, S.; Allison, P.; Conigliaro, J. Improvement through Small Cycles of Change: Lessons from an Academic Medical Center Emergency Department. J. Healthc. Qual. 2017, 39, 259–269. [CrossRef]50. Carter, P.M.; Desmond, J.S.; Akanbobnaab, C.; Oteng, R.A.; Rominski, S.D.; Barsan, W.G.; Cunningham, R.M. Optimizing clinical operations as part of a global emergency medicine initiative in Kumasi, Ghana: Application of lean manufacturing principals to low-resource health systems. Acad. Emerg. Med. 2012, 19, 338–347. [CrossRef]51. Dickson, E.W.; Anguelov, Z.; Bott, P.; Nugent, A.; Walz, D.; Singh, S. The sustainable improvement of patient flow in an emergency treatment centre using Lean. Int. J. Six Sigma Compet. Advant. 2008, 4, 289–304. [CrossRef]52. Dickson, E.W.; Anguelov, Z.; Vetterick, D.; Eller, A.; Singh, S. Use of Lean in the Emergency Department: A Case Series of 4 Hospitals. Ann. Emerg. Med. 2009, 54, 504–510. [CrossRef] [PubMed]53. Dickson, E.W.; Singh, S.; Cheung, D.S.; Wyatt, C.C.; Nugent, A.S. Application of Lean Manufacturing Techniques in the Emergency Department. J. Emerg. Med. 2009, 37, 177–182. [CrossRef]54. Elamir, H. Improving patient flow through applying lean concepts to emergency department. Lead. Health Serv. 2018, 31, 293–309. [CrossRef] [PubMed]55. Hitti, E.A.; El-Eid, G.R.; Tamim, H.; Saleh, R.; Saliba, M.; Naffaa, L. Improving Emergency Department radiology transportation time: A successful implementation of lean methodology. BMC Health Serv. Res. 2017, 17, 625. [CrossRef] [PubMed]56. Kane, M.; Chui, K.; Rimicci, J.; Callagy, P.; Hereford, J.; Shen, S.; Norris, R.; Pickham, D. Lean manufacturing improves emergency department throughput and patient satisfaction. J. Nurs. Admin. 2015, 45, 429–434. [CrossRef] [PubMed]57. Migita, R.; Del Beccaro, M.; Cotter, D.; Woodward, G.A. Emergency department overcrowding: Developing emergency department capacity through process improvement. Clin. Pediatr. Emerg. Med. 2011, 12, 141–150. [CrossRef]58. Murrell, K.L.; Offerman, S.R.; Kauffman, M.B. Applying Lean: Implementation of a rapid triage and treatment system. West. J. Emerg Med. 2011, 12, 184–191.59. Ng, D.; Vail, G.; Thomas, S.; Schmidt, N. Applying the Lean principles of the Toyota Production System to reduce wait times in the emergency department. Can. J. Emerg. Med. 2010, 12, 50–57. [CrossRef]60. Peng, L.S.; Rasid, M.F.; Salim, W.I. Using modified triage system to improve emergency department efficacy: A successful Lean implementation. Int. J. Healthc. Manag. 2019. [CrossRef]61. Polesello, V.; Dittadi, R.; Afshar, H.; Bassan, G.; Rosada, M.; Ninno, L.D.; Carraro, P. Improving pre-analytical laboratory turnaround time for the emergency department: Outcomes of a pneumatic tube system introduction. Biochim. Clin. 2019, 43, 150–155.62. Rotteau, L.; Webster, F.; Salkeld, E.; Hellings, C.; Guttmann, A.; Vermeulen, M.J.; Bell, R.S.; Zwarenstein, M.; Rowe,B.H.; Nigam,A.; etal. Ontario’semergency departmentprocess improvementprogram: Theexperience of implementation. Acad. Emerg. Med. 2015, 22, 720–729. [CrossRef] [PubMed]63. Sánchez, M.; Suárez, M.; Asenjo, M.; Bragulat, E. Improvement of emergency department patient flow using lean thinking. Int. J. Qual. Health Care 2018, 30, 250–256. [CrossRef] [PubMed]64. Sayed, M.J.E.; El-Eid, G.R.; Saliba, M.; Jabbour, R.; Hitti, E.A. Improving emergency department door to doctor time and process reliability: A successful implementation of lean methodology. Medicine 2015, 94, e1679. [CrossRef] [PubMed]65. Van Der Linden, M.C.; Van Ufford, H.M.E.; De Beaufort, R.A.Y.; Grauss, R.W.; Hofstee, H.M.A.; Hoogendoorn, J.M.; Meylaerts, S.A.G.; Rijsman, R.M.; De Rooij, T.P.W.; Smith, C.; et al. The impact of a multimodal intervention on emergency department crowding and patient flow. Int. J. Emerg. Med. 2019, 12, 21. [CrossRef]66. Vermeulen, M.J.; Stukel, T.A.; Guttmann, A.; Rowe, B.H.; Zwarenstein, M.; Golden, B.; Nigam, A.; Anderson, G.; Bell, R.S.; Schull, M.J. Evaluation of an emergency department lean process improvement program to reduce length of stay. Ann. Emerg. Med. 2014, 64, 427–438. [CrossRef]67. White, B.A.; Chang, Y.; Grabowski, B.G.; Brown, D.F.M. Using lean-based systems engineering to increase capacity in the emergency department. West. J. Emerg. Med. 2014, 15, 770–776. [CrossRef]68. Cheng, I.; Zwarenstein, M.; Kiss, A.; Castren, M.; Brommels, M.; Schull, M. Factors associated with failure of emergency wait-time targets for high acuity discharges and intensive care unit admissions. Can. J. Emerg. Med. 2018, 20, 112–124. [CrossRef]69. Forero, R.; Man, N.; McCarthy, S.; Richardson, D.; Mohsin, M.; Toloo, G.S.; FitzGerald, G.; Ngo, H.; Mountain, D.; Fatovich, D.; et al. Impact of the national emergency access target policy on emergency departments’ performance: A time-trend analysis for New South Wales, Australian capital territory and queensland. EMA Emerg. Med. Australas 2019, 31, 253–261. [CrossRef]70. Kaushik, N.; Khangulov, V.S.; O’hara, M.; Arnaout, R. Reduction in laboratory turnaround time decreases emergency room length of stay. Open Access Emerg. Med. 2018, 10, 37–45. [CrossRef]71. Maniaci, M.J.; Lachner, C.; Vadeboncoeur, T.F.; Hodge, D.O.; Dawson, N.L.; Rummans, T.A.; Roy, A.; Burton, M.C. Involuntary patient length-of-stay at a suburban emergency department. Am. J. Emerg. Med. 2019. [CrossRef]72. Singh, N.; Robinson, R.D.; Duane, T.M.; Kirby, J.J.; Lyell, C.; Buca, S.; Gandhi, R.; Mann, S.M.; Zenarosa, N.R.; Wang, H. Role of ED crowding relative to trauma quality care in a Level 1 Trauma Center. Am. J. Emerg. Med. 2019, 37, 579–584. [CrossRef] [PubMed]73. Street, M.; Mohebbi, M.; Berry, D.; Cross, A.; Considine, J. Influences on emergency department length of stay for older people. Eur. J. Emerg. Med. 2018, 25, 242–249. [CrossRef] [PubMed]74. Van der Veen, D.; Remeijer, C.; Fogteloo, A.J.; Heringhaus, C.; de Groot, B. Independent determinants of prolonged emergency department length of stay in a tertiary care centre: A prospective cohort study. Scand. J. Trauma Resusc. Emerg. Med. 2018, 26, 81. [CrossRef] [PubMed]75. Yau, F.F.; Tsai, T.; Lin, Y.; Wu, K.; Syue, Y.; Li, C. Can different physicians providing urgent and non-urgent treatment improve patient flow in emergency department? Am. J. Emerg. Med. 2018, 36, 993–997. [CrossRef] [PubMed]76. Brent, A.S.; Rahman, W.M.; Knarr, L.L.; Harrison, J.A.; Kearns, K.L.; Lindstrom, D.S. Reducing cycle times in pediatric emergency medicine. Pediatr. Emerg. Care 2009, 25, 307–311. [CrossRef] [PubMed]77. Fernandes, C.M.B.; Christenson, J.M. Use of continuous quality improvement to facilitate patient flow through the triage and Fast-Track areas of an emergency department. J. Emerg. Med. 1995, 13, 847–855. [CrossRef]78. Fernandes, C.M.B.; Christenson, J.M.; Price, A. Continuous quality improvement reduces length of stay for fast-track patients in an emergency department. Acad. Emerg. Med. 1996, 3, 258–263. [CrossRef]79. Higgins, G.L., III; Becker, M.H. A continuous quality improvement approach to IL-372 documentation compliance in an academic emergency department, and its impact on dictation costs, billing practices, and average patient length of stay. Acad. Emerg. Med. 2000, 7, 269–275. [CrossRef]80. Lovett, P.B.; Illg, M.L.; Sweeney, B.E. A Successful Model for a Comprehensive Patient Flow Management Center at an Academic Health System. Am. J. Med. Qual. 2014, 31, 246–255. [CrossRef]81. Preyde, M.; Crawford, K.; Mullins, L. Patients’ satisfaction and wait times at Guelph General Hospital Emergency Department before and after implementation of a process improvement project. Can. J. Emerg. Med. 2012, 14, 157–168. [CrossRef]82. Rehmani, R.; Amatullah, A.F. Quality improvement program in an Emergency Department. Saudi Med. J. 2008, 29, 418–422. [PubMed]83. Ajmi, F.; Zgaya, H.; Othman, S.B.; Hammadi, S. Agent-based dynamic optimization for managing the workflow of the patient’s pathway. Simul. Model. Pract. Theory 2019, 96, 101935. [CrossRef]84. Haydar, S.A.; Strout, T.D.; Baumann, M.R. Sustainable Mechanism to Reduce Emergency Department ( ED ) Length of Stay: The Use of ED Holding (ED Transition) Orders to Reduce ED Length of Stay. Acad. Emerg. Med. 2016, 23, 776–785. [CrossRef] [PubMed]85. Prybutok, G.L. Ninety to Nothing: A PDSA quality improvement project. Int. J. Health Care Qual. Assur. 2018, 31, 361–372. [CrossRef] [PubMed]86. Oueida, S.; Kotb, Y.; Aloqaily, M.; Jararweh, Y.; Baker, T. An edge computing based smart healthcare framework for resource management. Sensors 2018, 18, 4307. [CrossRef]87. Derni, O.; Boufera, F.; Khelfi, M.F. Coloured Petri net for modelling and improving emergency department based on the simulation model. Int. J. Simul. Process. Model. 2019, 14, 72–86. [CrossRef]88. Bellew, S.D.; Collins, S.P.; Barrett, T.W.; Russ, S.E.; Jones, I.D.; Slovis, C.M.; Self, W.H. Implementation of an Opioid Detoxification Management Pathway Reduces Emergency Department Length of Stay. Acad. Emerg. Med. 2018, 25, 1157–1163. [CrossRef]89. Than, M.P.; Pickering, J.W.; Dryden, J.M.; Lord, S.J.; Aitken, S.A.; Aldous, S.J.; Allan, K.E.; Ardagh, M.W.; Bonning, J.W.N.; Callender, R.; et al. ICare-ACS (Improving Care Processes for Patients with Suspected Acute Coronary Syndrome): A Study of Cross-System Implementation of a National Clinical Pathway. Circulation 2018, 137, 354–363. [CrossRef]90. Brouns, S.H.A.; Stassen, P.M.; Lambooij, S.L.E.; Dieleman, J.; Vanderfeesten, I.T.P.; Haak, H.R. Organisational factors induce prolonged emergency department length of stay in elderly patients—A retrospective cohort study. PLoS ONE 2015, 10, e135066. [CrossRef]91. Chan, T.C.; Killeen, J.P.; Kelly, D.; Guss, D.A. Impact of rapid entry and accelerated care at triage on reducing emergency department patient wait times, lengths of stay, and rate of left without being seen. Ann. Emerg. Med. 2005, 46, 491–497. [CrossRef] [PubMed]92. Christensen, M.; Rosenberg, M.; Mahon, E.; Pineda, S.; Rojas, E.; Soque, V.; Soque, V.; Johansen, M.L. Pivot Nursing: An Alternative to Traditional ED Triage. J. Emerg. Nurs. 2016, 42, 395–399. [CrossRef] [PubMed]93. Christianson, J.B.; Warrick, L.H.; Howard, R.; Vollum, J. Deploying Six Sigma in a health care system as a work in progress. Jt. Commun. J. Qual. Patient Saf. 2005, 31, 603–613. [CrossRef]94. DeFlitch, C.; Geeting, G.; Paz, H.L. Reinventing emergency department flow via healthcare delivery science. Health Environ. Res. Des. J. 2015, 8, 105–115. [CrossRef] [PubMed]95. Liu, Z.; Rexachs, D.; Epelde, F.; Luque, E. An agent-based model for quantitatively analyzing and predicting the complex behavior of emergency departments. J. Comput. Sci. 2017, 21, 11–23. [CrossRef]96. Oueida, S.; Kotb, Y.; Kadry, S.; Ionescu, S. Healthcare Operation Improvement Based on Simulation of Cooperative Resource Preservation Nets for None-Consumable Resources. Complexity 2018, 2018, 4102968. [CrossRef]97. Sloan, J.; Chatterjee, K.; Sloan, T.; Holland, G.; Waters, M.; Ewins, D.; Laundy, N. Effect of a pathway bundle on length of stay. Emerg. Med. J. 2009, 26, 479–483. [CrossRef]98. Stone-Griffith, S.; Englebright, J.D.; Cheung, D.; Korwek, K.M.; Perlin, J.B. Data-driven process and operational improvement in the emergency department: The ED Dashboard and Reporting Application. J. Healthc. Manag. 2012, 57, 167–181. [CrossRef]99. Bish, P.A.; McCormick, M.A.; Otegbeye, M. Ready-JET-Go: Split Flow Accelerates ED Throughput. J. Emerg. Nurs. 2016, 42, 114–119. [CrossRef]100. Blick, K.E. Providing critical laboratory results on time, every time to help reduce emergency department length of stay: How our laboratory achieved a six sigma level of performance. Am. J. Clin. Pathol. 2013, 140, 193–202. [CrossRef]101. Chadha, R.; Singh, A.; Kalra, J. Lean and queuing integration for the transformation of health care processes A lean health care model. Clin. Gov. 2012, 17, 191–199. [CrossRef]102. Chen, T.; Wang, C. Multi-objective simulation optimization for medical capacity allocation in emergency department. J. Simul. 2016, 10, 50–68. [CrossRef]103. Elalouf, A.; Wachtel, G. An alternative scheduling approach for improving patient-flow in emergency departments. Oper. Res. Health Care 2015, 7, 94–102. [CrossRef]104. Feng, Y.; Wu, I.; Chen, T. Stochastic resource allocation in emergency departments with a multi-objective simulation optimization algorithm. Health Care Manag. Sci. 2017, 20, 55–75. [CrossRef]105. Ferrand, Y.B.; Magazine, M.J.; Rao, U.S.; Glass, T.F. Managing responsiveness in the emergency department: Comparing dynamic priority queue with fast track. J. Oper Manag. 2018, 58–59, 15–26. [CrossRef]106. Furterer, S.L. Applying Lean Six Sigma methods to reduce length of stay in a hospital’s emergency department. Qual. Eng. 2018, 30, 389–404. [CrossRef]107. Ghanes, K.; Jouini, O.; Diakogiannis, A.; Wargon, M.; Jemai, Z.; Hellmann, R.; Thomas, V.; Koole, G. Simulation-based optimization of staffing levels in an emergency department. Simulation 2015, 91, 942–953. [CrossRef]108. Goienetxea Uriarte, A.; Ruiz Zúñiga, E.; Urenda Moris, M.; Ng, A.H.C. How can decision makers be supported in the improvement of an emergency department? A simulation, optimization and data mining approach. Oper. Res. Health Care 2017, 15, 102–122.109. He, S.; Sim, M.; Zhang, M. Data-driven patient scheduling in emergency departments: A hybrid robust-stochastic approach. Manag. Sci. 2019, 65, 4123–4140. [CrossRef]110. Huang, D.; Bastani, A.; Anderson, W.; Crabtree, J.; Kleiman, S.; Jones, S. Communication and bed reservation: Decreasing the length of stay for emergency department trauma patients. Am. J. Emerg. Med. 2018, 36, 1874–1879. [CrossRef]111. Kaner, M.; Gadrich, T.; Dror, S.; Marmor, Y.N. Generating and evaluating simulation scenarios to improve emergency department operations. IIE Trans. Healthc. Syst. Eng. 2014, 4, 156–166. [CrossRef]112. Lee, E.K.; Atallah, H.Y.; Wright, M.D.; Post, E.T.; Thomas, C.; Wu, D.T.; Haley, L.L. Transforming hospital emergency department workflow and patient care. Interfaces 2015, 45, 58–82. [CrossRef]113. Lo, M.D.; Rutman, L.E.; Migita, R.T.; Woodward, G.A. Rapid electronic provider documentation design and implementation in an academic pediatric emergency department. Pediatr. Emerg. Care 2015, 31, 798–804. [CrossRef] [PubMed]114. Oueida, S.; Kotb, Y.; Ionescu, S.; Militaru, G. AMS: A new platform for system design and simulation. Int, J. Simul. Model. 2019, 18, 33–46. [CrossRef]115. Rachuba, S.; Knapp, K.; Ashton, L.; Pitt, M. Streamlining pathways for minor injuries in emergency departments through radiographer-led discharge. Oper. Res. Health Care 2018, 19, 44–56. [CrossRef]116. Romano, E.; Guizzi, G.; Chiocca, D. A decision support tool, implemented in a system dynamics model, to improve the effectiveness in the hospital emergency department. Int. J. Procure Manag. 2015, 8, 141–168. [CrossRef]117. Ross, G.; Johnson, D.; Kobernick, M. Evaluation of a critical pathway for stroke. J. Am. Osteopath Assoc. 1997, 97, 269–276. [CrossRef] [PubMed]118. Ross, A.J.; Murrells, T.; Kirby, T.; Jaye, P.; Anderson, J.E. An integrated statistical model of Emergency Department length of stay informed by Resilient Health Care principles. Saf. Sci. 2019, 120, 129–136. [CrossRef]119. Shin, S.Y.; Brun, Y.; Balasubramanian, H.; Henneman, P.L.; Osterweil, L.J. Discrete-Event Simulation and Integer Linear Programming for Constraint-Aware Resource Scheduling. IEEE Trans. Syst. Man Cybern. Syst. 2018, 48, 1578–1593. [CrossRef]120. Sinreich, D.; Jabali, O. Staggered work shifts: A way to downsize and restructure an emergency department workforce yet maintain current operational performance. Health Care Manag. Sci 2007, 10, 293–308. [CrossRef]121. Sinreich, D.; Jabali, O.; Dellaert, N.P. Reducing emergency department waiting times by adjusting work shifts considering patient visits to multiple care providers. IIE Trans. 2012, 44, 163–180. [CrossRef]122. Sir, M.Y.; Nestler, D.; Hellmich, T.; Das, D.; Laughlin, M.J.; Dohlman, M.C.; Pasupathy, K. Optimization of multidisciplinary staffing improves patient experiences at the mayo clinic. Interfaces 2017, 47, 425–441. [CrossRef]123. Techar, K.; Nguyen, A.; Lorenzo, R.M.; Yang, S.; Thielen, B.; Cain-Nielsen, A.; Hemmila, M.R.; Tignanelli, C.J. Early Imaging Associated With Improved Survival in Older Patients With Mild Traumatic Brain Injuries. J. Surg. Res. 2019, 242, 4–10. [CrossRef]124. Visintin, F.; Caprara, C.; Puggelli, F. Experimental design and simulation applied to a pediatric emergency department: A case study. Comput. Ind. Eng. 2019, 128, 755–781. [CrossRef]125. Yousefi, M.; Ferreira, R.P.M. An agent-based simulation combined with group decision-making technique for improving the performance of an emergency department. Braz. J. Med. Biol. Res. 2017, 50. [CrossRef]126. Yousefi, M.; Yousefi, M.; Ferreira, R.P.M.; Kim, J.H.; Fogliatto, F.S. Chaotic genetic algorithm and Adaboost ensemble metamodeling approach for optimum resource planning in emergency departments. Artif. Intell. Med. 2018, 84, 23–33. [CrossRef]127. Yousefi, M.; Yousefi, M.; Fogliatto, F.S.; Ferreira, R.P.M.; Kim, J.H. Simulating the behavior of patients who leave a public hospital emergency department without being seen by a physician: A cellular automaton and agent-based framework. Braz. J. Med. Biol. Res. 2018, 51. [CrossRef]128. Zeltyn, S.; Marmor, Y.N.; Mandelbaum, A.; Carmeli, B.; Greenshpan, O.; Mesika, Y.; Wasserkrug, S.; Vortman, P.; Shtub, A.; Lauterman, T.; et al. Simulation-based models of emergency departments: Operational, tactical, and strategic staffing. ACM Trans. Model. Comput. Simul. 2011, 21, 1–25. [CrossRef]129. Ashour, O.M.; Okudan Kremer, G.E. A simulation analysis of the impact of FAHP-MAUT triage algorithm on the Emergency Department performance measures. Expert Syst. Appl. 2013, 40, 177–187. [CrossRef]130. Aroua, A.; Abdulnour, G. Optimization of the emergency department in hospitals using simulation and experimental design: Case study. Procedia Manuf. 2018, 17, 878–885. [CrossRef]131. Abo-Hamad, W.; Arisha, A. Simulation-based framework to improve patient experience in an emergency department. Eur. J. Oper. Res. 2013, 224, 154–166. [CrossRef]132. Acuna, J.A.; Zayas-Castro, J.L.; Charkhgard, H. Ambulance allocation optimization model for the overcrowding problem in US emergency departments: A case study in Florida. Socio-Econ. Plan. Sci. 2019. [CrossRef]133. Ala, A.; Chen, F. Alternative mathematical formulation and hybrid meta-heuristics for patient scheduling problem in health care clinics. Neural Comput. Appl. 2019, in press. [CrossRef]134. Yousefi, M.; Yousefi, M. Human resource allocation in an emergency department: A metamodel-based simulation optimization. Kybernetes 2019, 49, 779–796. [CrossRef]135. Duguay, C.; Chetouane, F. Modeling and Improving Emergency Department Systems using Discrete Event Simulation. Simulation 2007, 83, 311–320. [CrossRef]136. Ibrahim, I.M.; Liong, C.; Bakar, S.A.; Ahmad, N.; Najmuddin, A.F. Estimating optimal resource capacities in emergency department. Indian J. Public Health Res. Dev. 2018, 9, 1558–1565. [CrossRef]137. Joshi, V.; Lim, C.; Teng, S.G. Simulation Study: Improvement for Non-Urgent Patient Processes in the Emergency Department. EMJ Eng. Manag. J. 2016, 28, 145–157. [CrossRef]138. Kaushal, A.; Zhao, Y.; Peng, Q.; Strome, T.; Weldon, E.; Zhang, M.; Chochinov, A. Evaluation of fast track strategies using agent-based simulation modeling to reduce waiting time in a hospital emergency department. Socio-Econ. Plan. Sci. 2015, 50, 18–31. [CrossRef]139. Lamprecht, J.; Kolisch, R.; Pförringer, D. The impact of medical documentation assistants on process performance measures in a surgical emergency department. Eur. J. Med. Res. 2019, 24, 1–8. [CrossRef]140. Taboada, M.; Cabrera, E.; Epelde, F.; Iglesias, M.L.; Luque, E. Agent-based emergency decision-making aid for hospital emergency departments. Emergencias 2012, 24, 189–195.141. Wang, J.; Li, J.; Tussey, K.; Ross, K. Reducing length of stay in emergency department: A simulation study at a community hospital. IEEE Trans. Syst. Man Cybern. Part. A Syst. Hum. 2012, 42, 1314–1322. [CrossRef]142. Yang, K.K.; Lam, S.S.W.; Low, J.M.W.; Ong, M.E.H. Managing emergency department crowding through improved triaging and resource allocation. Oper. Res. Health Care 2016, 10, 13–22. [CrossRef]143. Hogan, B.; Rasche, C.; Von Reinersdorff, A.B. The First View Concept: Introduction of industrial flow techniques into emergency medicine organization. Eur. J. Emerg. Med. 2012, 19, 136–139. [CrossRef]144. Ieraci, S.; Digiusto, E.; Sonntag, P.; Dann, L.; Fox, D. Streaming by case complexity: Evaluation of a model for emergency department Fast Track. EMA Emerg. Med. Australas 2008, 20, 241–249. [CrossRef]145. Improta, G.; Romano, M.; Di Cicco, M.V.; Ferraro, A.; Borrelli, A.; Verdoliva, C.; Triassi, M.; Cesarelli, M. Lean thinking to improve emergency department throughput at AORN Cardarelli hospital. BMC Health Serv. Res. 2018, 18, 914. [CrossRef]146. Piggott, Z.; Weldon, E.; Strome, T.; Chochinov, A. Application of lean principles to improve early cardiac care in the emergency department. Can. J. Emerg. Med. 2011, 13, 325–332. [CrossRef]147. Rees, G.H. Organisational readiness and Lean Thinking implementation: Findings from three emergency department case studies in New Zealand. Health Serv. Manag. Res. 2014, 27, 1–9. [CrossRef]148. Rutman, L.E.; Migita, R.; Woodward, G.A.; Klein, E.J. Creating a leaner pediatric emergency department: How rapid design and testing of a front-end model led to decreased wait time. Pediatr. Emerg. Care 2015, 31, 395–398. [CrossRef]149. Vashi, A.A.; Sheikhi, F.H.; Nashton, L.A.; Ellman, J.; Rajagopal, P.; Asch, S.M. Applying Lean Principles to Reduce Wait Times in a VA Emergency Department. Mil. Med. 2019, 184, E169–E178. [CrossRef]150. White, B.A.; Yun, B.J.; Lev, M.H.; Raja, A.S. Applying systems engineering reduces radiology transport cycle times in the emergency department. West. J. Emerg. Med. 2017, 18, 410–418. [CrossRef]151. Bordoloi, S.K.; Beach, K. Improving operational efficiency in an Inner-city Emergency Department. Health Serv. Manag. Res. 2007, 20, 105–112. [CrossRef]152. Meng, F.; Teow, K.L.; Ooi, C.K.; Heng, B.H.; Tay, S.Y. Minimization of the coefficient of variation for patient waiting system governed by a generic maximum waiting policy. J. Ind. Manag. Optim. 2017, 13, 1759–1770. [CrossRef]153. Leo, G.; Lodi, A.; Tubertini, P.; Di Martino, M. Emergency Department Management in Lazio, Italy. Omega 2016, 58, 128–138. [CrossRef]154. Nezamoddini, N.; Khasawneh, M.T. Modeling and optimization of resources in multi-emergency department settings with patient transfer. Oper. Res. Health Care 2016, 10, 23–34. [CrossRef]155. Rothwell, S.; McIltrot, K.; Khouri-Stevens, Z. Addressing Emergency Department Issues Using Advanced Practice in Saudi Arabia. J. Nurse Pract. 2018, 14, e41–e44. [CrossRef]156. Spaite, D.W.; Bartholomeaux, F.; Guisto, J.; Lindberg, E.; Hull, B.; Eyherabide, A.; Lanyon, S.; Criss, E.A.; Valenzuela, T.D.; Conroy, C. Rapid process redesign in a university-based emergency department: Decreasing waiting time intervals and improving patient satisfaction. Ann. Emerg. Med. 2002, 39, 168–177. [CrossRef]157. Doupe, M.B.; Chateau, D.; Chochinov, A.; Weber, E.; Enns, J.E.; Derksen, S.; Sarkar, J.; Schull, M.; Lobato de Faria, R.; Katz, A.; et al. Comparing the Effect of Throughput and Output Factors on Emergency Department Crowding: A Retrospective Observational Cohort Study. Ann. Emerg. Med. 2018, 72, 410–419. [CrossRef]158. Eiset, A.H.; Kirkegaard, H.; Erlandsen, M. Crowding in the emergency department in the absence of boarding—A transition regression model to predict departures and waiting time. BMC Med. Res. Methodol. 2019, 19, 68. [CrossRef]159. Cookson, D.; Read, C.; Mukherjee, P.; Cooke, M. Improving the quality of Emergency Department care by removing waste using Lean Value Stream mapping. Int. J. Clin. Lead. 2011, 17, 25–30.160. Fulbrook, P.; Jessup, M.; Kinnear, F. Implementation and evaluation of a ‘Navigator’ role to improve emergency department throughput. Australas Emerg. Nurs. J. 2017, 20, 114–121. [CrossRef]161. Popovich, M.A.; Boyd, C.; Dachenhaus, T.; Kusler, D. Improving Stable Patient Flow through the Emergency Department by Utilizing Evidence-Based Practice: One Hospital’s Journey. J. Emerg. Nurs. 2012, 38, 474–478. [CrossRef]162. Aminuddin, W.M.W.M.; Ismail, W.R.; Harunarashid, H. Resources improvement in emergency department using simulation and data envelopment analysis. Sains Malays. 2018, 47, 2231–2240.163. Andersen, A.R.; Nielsen, B.F.; Reinhardt, L.B.; Stidsen, T.R. Staff optimization for time-dependent acute patient flow. Eur. J. Oper. Res. 2019, 272, 94–105. [CrossRef]164. Zhao, Y.; Peng, Q.; Strome, T.; Weldon, E.; Zhang, M.; Chochinov, A. Bottleneck detection for improvement of emergency department efficiency. Bus. Process. Manag. J. 2015, 21, 564–585. [CrossRef]165. Azadeh, A.; Hosseinabadi Farahani, M.; Torabzadeh, S.; Baghersad, M. Scheduling prioritized patients in emergency department laboratories. Comput. Methods Programs Biomed. 2014, 117, 61–70. [CrossRef]166. Bal, A.; Ceylan, C.; Taçog˘lu, C. Using value stream mapping and discrete event simulation to improve efficiency of emergency departments. Int. J. Healthc. Manag. 2017, 10, 196–206. [CrossRef]167. Benson, R.; Harp, N. Using systems thinking to extend continuous quality improvement. Qual. Lett. Healthc. Lead. 1994, 6, 17–24.168. Daldoul, D.; Nouaouri, I.; Bouchriha, H.; Allaoui, H. A stochastic model to minimize patient waiting time in an emergency department. Oper. Res. Health Care 2018, 18, 16–25. [CrossRef]169. Diefenbach, M.; Kozan, E. Effects of bed configurations at a hospital emergency department. J. Simul. 2011, 5, 44–57. [CrossRef]170. EL-Rifai, O.; Garaix, T.; Augusto, V.; Xie, X. A stochastic optimization model for shift scheduling in emergency departments. Health Care Manag. Sci. 2015, 18, 289–302. [CrossRef]171. Gartner, D.; Padman, R.Machine learning for healthcare behaviouralOR: Addressing waitingtime perceptions in emergency care. J. Oper. Res. Soc. 2019. [CrossRef]172. González, J.; Ferrer, J.; Cataldo, A.; Rojas, L. A proactive transfer policy for critical patient flow management. Health Care Manag. Sci. 2019, 22, 287–303. [CrossRef]173. Izady, N.; Worthington, D. Setting staffing requirements for time dependent queueing networks: The case of accident and emergency departments. Eur. J. Oper. Res. 2012, 219, 531–540. [CrossRef]174. Kuo, Y.H. Integrating simulation with simulated annealing for scheduling physicians in an understaffed emergency department. Hong Kong Inst. Eng. Trans. 2014, 21, 253–261. [CrossRef]175. Lau, H.; Dadich, A.; Nakandala, D.; Evans, H.; Zhao, L. Development of a cost-optimization model to reduce bottlenecks: A health service case study. Expert Syst. 2018, 35, e12294. [CrossRef]176. Martínez, P.; Martínez, J.; Nuño, P.; Cavazos, J. Improvement of patient care time in an emergency department through the application of lean manufacturing. Inf. Tecnol. 2015, 26, 187–198. [CrossRef]177. Mazzocato, P.; Holden, R.J.; Brommels, M.; Aronsson, H.; Bäckman, U.; Elg, M.; Thor, J. How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children’s hospital, Stockholm, Sweden. BMC Health Serv. Res. 2012, 12, 28. [CrossRef]178. Ben Othman, S.; Zgaya, H.; Hammadi, S.; Quilliot, A.; Martinot, A.; Renard, J. Agents endowed with uncertainty management behaviors to solve a multiskill healthcare task scheduling. J. Biomed. Inform. 2016, 64, 25–43. [CrossRef]179. Ben Othman, S.; Hammadi, S. A multi-criteria optimization approach to health care tasks scheduling under resources constraints. Int. J. Comput. Intell. Syst. 2017, 10, 419–439. [CrossRef]180. Perry, A. Code Critical: Improving Care Delivery for Critically Ill Patients in the Emergency Department. J. Emerg. Nurs. 2019, 46, 199–204. [CrossRef]181. Stephens, A.S.; Broome, R.A. Impact of emergency department occupancy on waiting times, rates of admission and representation, and length of stay when hospitalised: A data linkage study. EMA Emerg. Med. Australas 2019, 31, 555–561. [CrossRef]182. Umble, M.; Umble, E.J. Utilizing buffer management to improve performance in a healthcare environment. Eur. J. Oper. Res. 2006, 174, 1060–1075. [CrossRef]183. Xu, K.; Chan, C.W. Using future information to reduce waiting times in the emergency department via diversion. Manuf. Serv. Oper. Manag. 2016, 18, 314–331. [CrossRef]184. Zeinali, F.; Mahootchi, M.; Sepehri, M.M. Resource planning in the emergency departments: A simulation-based metamodeling approach. Simul. Model. Pract. Theory 2015, 53, 123–138. [CrossRef]185. Ahalt, V.; Argon, N.T.; Ziya, S.; Strickler, J.; Mehrotra, A. Comparison of emergency department crowding scores: A discrete-event simulation approach. Health Care Manag. Sci. 2018, 21, 144–155. [CrossRef]186. Fitzgerald, J.A.; Eljiz, K.; Dadich, A.; Sloan, T.; Hayes, K.J. Health services innovation: Evaluating process changes to improve patient flow. Int. J. Healthc. Technol. Manag. 2011, 12, 280–292. [CrossRef]187. Peck, J.S.; Benneyan, J.C.; Nightingale, D.J.; Gaehde, S.A. Characterizing the value of predictive analytics in facilitating hospital patient flow. IIE Trans. Healthc. Syst. Eng. 2014, 4, 135–143. [CrossRef]188. Restrepo-Zea, J.H.; Jaén-Posada, J.S.; Piedrahita, J.J.E.; Flórez, P.A.Z. Emergency department overcrowding: A four-hospital analysis in Medellín and a strategy simulation. Rev. Gerenc. Polit. Salud 2018, 17, 130–144.189. Aaronson, E.; Mort, E.; Soghoian, S. Mapping the process of emergency care at a teaching hospital in Ghana. Healthcare 2017, 5, 214–220. [CrossRef]190. Al Owad, A.; Samaranayake, P.; Karim, A.; Ahsan, K.B. An integrated lean methodology for improving patient flow in an emergency department–case study of a Saudi Arabian hospital. Prod. Plan. Control 2018, 29, 1058–1081. [CrossRef]191. Vose, C.; Reichard, C.; Pool, S.; Snyder, M.; Burmeister, D. Using LEAN to improve a segment of emergency department flow. J. Nurs. Admin. 2014, 44, 558–563. [CrossRef]192. Hu, B.; Wang, Z.; Wang, S.; He, L.; Wu, J.; Wang, F.; Zhu, X.; Gu, S. Key factors affecting the correlation between improving work efficiency and emergency department overcrowding in the tertiary level A hospitals. Chin. J. Emerg. Med. 2018, 27, 943–948.193. Wang, X. Emergency department staffing: A separated continuous linear programming approach. Math. Probl. Eng. 2013, 2013, 680152. [CrossRef]194. Aldarrab, A. Application of Lean Six Sigma for patients presenting with ST-elevation myocardial infarction: The Hamilton Health Sciences experience. Healthc. Q. 2006, 9, 56–61. [CrossRef]195. Beck, M.J.; Okerblom, D.; Kumar, A.; Bandyopadhyay, S.; Scalzi, L.V. Lean intervention improves patient discharge times, improves emergency department throughput and reduces congestion. Hosp. Pract. 2016, 44, 252–259. [CrossRef]196. El-Rifai, O.; Garaix, T.; Xie, X. Proactive on-call scheduling during a seasonal epidemic. Oper. Res. Health Care 2016, 8, 53–61. [CrossRef]197. Garrett, J.S.; Berry, C.; Wong, H.; Qin, H.; Kline, J.A. The effect of vertical split-flow patient management on emergency department throughput and efficiency. Am. J. Emerg. Med. 2018, 36, 1581–1584. [CrossRef]198. Hussein, N.A.; Abdelmaguid, T.F.; Tawfik, B.S.; Ahmed, N.G.S. Mitigating overcrowding in emergency departments using Six Sigma and simulation: A case study in Egypt. Oper. Res. Health Care 2017, 15, 1–12. [CrossRef]199. Landa, P.; Sonnessa, M.; Tànfani, E.; Testi, A. Multiobjective bed management considering emergency and elective patient flows. Int. Trans. Oper. Res. 2018, 25, 91–110. [CrossRef]200. Peltan, I.D.; Bledsoe, J.R.; Oniki, T.A.; Sorensen, J.; Jephson, A.R.; Allen, T.L.; Samore, M.H.; Hough, C.L.; Brown, S.M. Emergency Department Crowding Is Associated With Delayed Antibiotics for Sepsis. Ann. Emerg. Med. 2019, 73, 345–355. [CrossRef]201. Khanna, S.; Sier, D.; Boyle, J.; Zeitz, K. Discharge timeliness and its impact on hospital crowding and emergency department flow performance. EMA Emerg. Med. Australas 2016, 28, 164–170. [CrossRef]202. Vile, J.L.; Allkins, E.; Frankish, J.; Garland, S.; Mizen, P.; Williams, J.E. Modelling patient flow in an emergency department to better understand demand management strategies. J. Simul. 2017, 11, 115–127. [CrossRef]203. Matt, D.T.; Arcidiacono, G.; Rauch, E. Applying lean to healthcare delivery processes—A case-based. Int. J. Adv. Sci. Eng. Inf. Technol. 2018, 8, 123–133. [CrossRef]204. Goldmann, D.A.; Saul, C.A.; Parsons, S.; Mansoor, C.; Abbott, A.; Damian, F.; Young, G.J.; Homer, C.; Caputo, G.L. Hospital-based continuous quality improvement: A realistic appraisal. Clin. Perform. Qual. Health Care 1993, 1, 69–80.205. Henderson, D.; Dempsey, C.; Larson, K.; Appleby, D. The impact of IMPACT on St. John’s Regional Health Center. Mo. Med. 2003, 100, 590–592.206. Jackson, G.; Andrew, J. Using a multidisciplinary CQI approach to reduce ER-to-floor admission time. J. Healthc. Qual. 1996, 18, 18–21. [CrossRef]207. Markel, K.N.; Marion, S.A. CQI: Improving the time to thrombolytic therapy for patients with acute myocardial infarction in the emergency department. J. Emerg. Med. 1996, 14, 685–689. [CrossRef]208. Courtad, B.; Baker, K.; Magazine, M.; Polak, G. Minimizing flowtime for paired tasks. Eur. J. Oper. Res. 2017, 259, 818–828. [CrossRef]209. Iyer, S.; Reeves, S.; Varadarajan, K.; Alessandrini, E. The acute care model: A new framework for quality care in emergency medicine. Clin. Pediatr. Emerg. Med. 2011, 12, 91–101. [CrossRef]210. Mohan, S.; Nandi, D.; Stephens, P.; M’Farrej, M.; Vogel, R.L.; Bonafide, C.P. Implementation of a clinical pathway for chest pain in a pediatric emergency department. Pediatr. Emerg. Care 2018, 34, 778–782. [CrossRef]211. Ollivere, B.; Rollins, K.; Brankin, R.; Wood, M.; Brammar, T.J.; Wimhurst, J. Optimising fast track care for proximal femoral fracture patients using modified early warning score. Ann. R. Coll. Surg. Engl. 2012, 94, e267–e271. [CrossRef]212. Azadeh, A.; Rouhollah, F.; Davoudpour, F.; Mohammadfam, I. Fuzzy modelling and simulation of an emergency department for improvement of nursing schedules with noisy and uncertain inputs. Int. J. Serv. Oper. Manag. 2013, 15, 58–77. [CrossRef]213. Brenner, S.; Zeng, Z.; Liu, Y.; Wang, J.; Li, J.; Howard, P.K. Modeling and analysis of the emergency department at university of Kentucky Chandler Hospital using simulations. J. Emerg. Nurs. 2010, 36, 303–310. [CrossRef]214. Guo, H.; Gao, S.; Tsui, K.; Niu, T. Simulation Optimization for Medical Staff Configuration at Emergency Department in Hong Kong. IEEE Trans. Autom. Sci. Eng. 2017, 14, 1655–1665. [CrossRef]215. Hajjarsaraei, H.; Shirazi, B.; Rezaeian, J. Scenario-based analysis of fast track strategy optimization on emergency department using integrated safety simulation. Saf. Sci. 2018, 107, 9–21. [CrossRef]216. Huang,Y.; Klassen,K.J.Usingsixsigma, lean, andsimulationtoimprovethephlebotomyprocess. Qual.Manag. J. 2016, 23, 6–21. [CrossRef]217. Keeling, K.B.; Brown, E.; Kros, J.F. Using process capability analysis and simulation to improve patient flow. Appl. Manag. Sci. 2013, 16, 219–229.218. Ryan, A.; Hunter, K.; Cunningham, K.; Williams, J.; O’Shea, H.; Rooney, P.; Hickey, F. STEPS: Lean thinking, theory of constraints and identifying bottlenecks in an emergency department. Ir. Med. J. 2013, 106, 105–107.219. Shirazi, B. Fast track system optimization of emergency departments: Insights from a computer simulation study. Int. J. Model. Simul. Sci. Comput. 2016, 7, 1650015. [CrossRef]220. Stanton, P.; Gough, R.; Ballardie, R.; Bartram, T.; Bamber, G.J.; Sohal, A. Implementing lean management/Six Sigma in hospitals: Beyond empowerment or work intensification? Int. J. Hum. Resour. Manag. 2014, 25, 2926–2940. [CrossRef]221. Weimann, E. Lean management and continuous improvement process in hospitals. Pneumologe 2018, 15, 202–208. [CrossRef]222. Hitti, E.; Hadid, D.; Tamim, H.; Al Hariri, M.; El Sayed, M. Left without being seen in a hybrid point of service collection model emergency department. Am. J. Emerg. Med. 2019. [CrossRef]223. Jiang, S.; Chin, K.; Tsui, K.L. A universal deep learning approach for modeling the flow of patients under different severities. Comput. Methods Programs Biomed. 2018, 154, 191–203. [CrossRef]224. Welch, S.J.; Allen, T.L. Data-driven quality improvement in the Emergency Department at a level one trauma and tertiary care hospital. J. Emerg. Med. 2006, 30, 269–276. [CrossRef]225. Schwab, R.A.; DelSorbo, S.M.; Cunningham, M.R.; Craven, K.; Watson, W.A. Using statistical process control to demonstrate the effect of operational interventions on quality indicators in the emergency department. J. Healthc. Qual. 1999, 21, 38–41. [CrossRef]226. Nuñez-Perez, N.; Ortíz-Barrios, M.; McClean, S.; Salas-Navarro, K.; Jimenez-Delgado, G.; Castillo-Zea, A. Discrete-event simulation to reduce waiting time in accident and emergency departments: A case study in a district general clinic. In Lecture Notes in Computer Science; 10586 LNCS:352-363; Springer: Cham, Switzerland, 2017.227. Troncoso-Palacio, A.; Neira-Rodado, D.; Ortíz-Barrios, M.; Jiménez-Delgado, G.; Hernández-Palma, H. Using discrete-event-simulation for improving operational efficiency in laboratories: A case study in pharmaceutical industry. In Lecture Notes in Computer Science; 10942 LNCS:440-451; Springer: Cham, Switzerland, 2018.228. Ortiz-Barrios, M.; Pancardo, P.; Jiménez-Delgado, G.; De Ávila-Villalobos, J. Applying Multi-phase DES Approach for Modelling the Patient Journey Through Accident and Emergency Departments. In Lecture Notes in Computer Science; 11582 LNCS:87-100; Springer: Cham, Switzerland, 2019.229. Ortiz, M.A.; McClean, S.; Nugent, C.D.; Castillo, A. Reducing appointment lead-time in an outpatient department of gynecology and obstetrics through discrete-event simulation: A case study. In Lecture Notes in Computer Science; 10069 LNCS:274-285; Springer: Cham, Switzerland, 2016.230. World Health Organization (WHO); Organisation for Economic Co-operation and Development ( OECD); World Bank Group. Delivering Quality Health Services: A Global Imperative for Universal Health Coverage; Licence: CC BY-NC-SA 3.0 IGO; World Health Organization, Organisation for Economic Co-operation and Development, and The World Bank: Geneva, Switzerland, 2018.PublicationORIGINALMethodological approaches to support process improvement in emergency departments. a systematic review.pdfMethodological approaches to support process improvement in emergency departments. a systematic review.pdfapplication/pdf1247155https://repositorio.cuc.edu.co/bitstreams/4272a193-b16e-4233-a6b0-9d027c236624/downloadc8da5e392c5e14f1444093b61bc30430MD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8701https://repositorio.cuc.edu.co/bitstreams/71140406-5204-4e5e-869a-e55501c89c95/download42fd4ad1e89814f5e4a476b409eb708cMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-81748https://repositorio.cuc.edu.co/bitstreams/fed4e31d-dcc1-41f7-9ca6-954406aa841e/download8a4605be74aa9ea9d79846c1fba20a33MD53THUMBNAILMethodological approaches to support process improvement in emergency departments. a systematic review.pdf.jpgMethodological approaches to support process improvement in emergency departments. a systematic review.pdf.jpgimage/jpeg68403https://repositorio.cuc.edu.co/bitstreams/1fa61cb8-68bc-4041-9bf9-79dbd978a6b5/download026e617f6fe12837e1088b0bec3e1145MD54THUMBNAILMethodological approaches to support process improvement in emergency departments. a systematic review.pdf.jpgMethodological approaches to support process improvement in emergency departments. a systematic review.pdf.jpgimage/jpeg68403https://repositorio.cuc.edu.co/bitstreams/8be919b4-3848-4711-b8da-f94b169b512a/download026e617f6fe12837e1088b0bec3e1145MD54TEXTMethodological approaches to support process improvement in emergency departments. a systematic review.pdf.txtMethodological approaches to support process improvement in emergency departments. a systematic review.pdf.txttext/plain158503https://repositorio.cuc.edu.co/bitstreams/7656ac79-c7fc-47ff-b224-7c05ad72f442/download67280d1fbda686c5c06c46dd0477bf51MD5511323/6244oai:repositorio.cuc.edu.co:11323/62442024-09-17 14:09:00.043http://creativecommons.org/publicdomain/zero/1.0/CC0 1.0 Universalopen.accesshttps://repositorio.cuc.edu.coRepositorio de la Universidad de la Costa CUCrepdigital@cuc.edu.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

Publicaciones similares