A decision support tool for a hospital emergency service based on quality of care measurement parameters
DOI:
https://doi.org/10.21754/tecnia.v13i2.488Keywords:
Quality of Care, Systems modeling, healthcare medicine emergency, discrete stochastic simulation and decision-making supportAbstract
Decision making in the emergency area, given its implication of caring for patients at risk, is extremely sensitive. An inappropriate decision can
make the difference between life and death. The system must respond quickly, efficiently and effectively, and the medical human factor plays the leading role. It can be concluded then that the adequate distribution of the human potential available at the time of emergency is decisive in providing adequate care to the patient. In this work, a model is presented that estimates the appropriate configurations of
medical equipment in the emergency area, based on parameters measured quantitatively by simulation, which are used to estimate the quality of
the attention. These parameters support each of the response requirements. There are parameters based on the control of response time, to
ensure speed of care according to the patient's urgency. In addition, there are other parameters that control whether the patient was treated by the medical team.
necessary, according to its urgency, at the appropriate time, and at all times in which, within the department, the patient needed a medical team for their care. The doctor-patient relationship was modeled from both aspects of the doctor and the patients. The patients were modeled according to their urgency, considering four types of patients. The work of the medical staff was modeled taking into account characteristic aspects of medical work, such as their teamwork, the parallelism in patient care of the various medical teams, the work hierarchy within the formation of the teams, and the possibility that the most experienced doctor be part of all medical teams where his participation is necessary. This tool can be used to support decision-making related to the scheduling of medical personnel in the emergency area of a hospital, and has been validated with statistical data from two hospitals, the Antonio Pedro hospital (Niteriói-Brazil) and the Cayetano Heredia Hospital (Lima-Peru).
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[1] . Deslandes, S.F. "O atendimento às vítimas de violência na emergência: Prevenção numa hora dessas" In: Ciência & Saúde Coletiva, 4(1), 81- 94, 1999.
[2] . M.J.F. de Oliveira, "An integrated decision support system for planning of emergency and elective admissions to hospital wards". In: 24th Annual meeting of OR applied to health services, Roma, Italia, 1998.
[3] . F. de Oliveira, M.J., P. Toscano, L.N. "An integrated emergency information support system IEISS". In: 25th Annual meeting of OR applied to health services (EURO), Latvia, 1999.
[4] . Mcguire, F. "Using simulation to reduce length of stay in emergency departments". Jsoc Health Syst, 5(3): 81-90, 1997.
[5] . P. Toscano, L.N., F. de Oliveira, M.J. "Models of the Emergency attention to Patients". World congress on medical physics and biomedical engineering, July 23-28, Chicago, USA. http://www.medphys.org, 2000.
[6] . P. Toscano, L.N., M.J.F. de Oliveira, "An integrated emergency information support system". World congress on medical physics and biomedical engineering, July 23-28, Chicago, USA. http://www.medphys.org. 2000.
[7] . Washington, M.A., Khator, L. Michael, Suresh, K. "Computer simulation in health care". Annual quest for quality and productivity in health services conference. IIE, Norcross, GA, USA, 201-210, 1997.
[8] . Lagergren, M. "What is the role and contribution of models to management and research in the health services". European Journal of Operational Research, 105(2), 257-266, 1998.
[9] . Largergren, M. "Modelling as a tool to assist in managing problems in health care". In D. Boldy, J. Boldy, J. Braithwaite and I. Forbes (editors). Evidence based management in health care: The role of decision support systems. Asustralian studies in health service administration, Australia, 2002.
[10] . F. de Oliveira, M.J. "A patient-oriented modeling of the emergency admission systems of a brazilian hospital". Paper presented at EURO XIII, Glasgow, July 19-22, 1994.
[11]. Pidd, M., De Silva, F.N., Eglese, R.W. "A simulation model for emergency evacuation". European Journal of Operational Research, 90 (3), 413-419, 1996.
[12] . Chaiken, J., Larson, R. "Methods for allocating urban emergency units: a survey". Management Science, 19, 110-130, 1998.
[13] . Savas, E. "Simulation and cost-effectiveness analysis of New York's emergency ambulance service". Management Science 15 August, 1969.
[14] . Lehaney, B., Paul, R.J. "Use of soft systems methodology in the development of a simulation of out-patient services at Watford General Hospital". Journal of the Operational Research
Society, 47(1), 864-870, July, 1996.
[15] . F. de Oliveira, M.J., P. Toscano, L.N. "Emergency information suport system for brazilian public hospital". In M.S. Rauner and K. Heidenberger (editors), Quantitative approaches in health care management, Peter Lang, Frankfurt am Main, Berlin, Bern, Bruxelles, New York, Wien, Oxford, 235-251, 2003.
[16] . P. Toscano, L.N. "Uma ferramenta integrada de suporte a decisões em casos de emergências médicas hospitalares", Dsc Thesis, Federal University of Rio de Janeiro, 2001.
[17] . Morales, C., Escalona, E. «Triage extra e intrahospitalario». Manual de Urgencias y Reanimación Fundación Lucas Sierra, Viña del Mar, Volumen N°1, págs 4:14-4:29. 1990-1991.
[18] . Perez, I., Montaut Merino, CarrilloBecerra, I., Cases Garrido, A., Lirio Fernández, M. D. "Sistemas de Garantia de Calidad en Urgencias y Emergencias". Cuidados Críticos y Emergencias. Centro de Salud de Las Lagunas. Málaga - España. http://www.medynet.com/usuarios/jraguilar/joserra.html.
[19] . Mobley Sheryl, C. S. "Medical Staff Management: Forms, Policies, and Proceduresfor Health Care Providers. Aspen Publishers, Inc., Book and Disk edition - January 1996. ISBN:
[20] . Ordner, R., Weitl, J. "Calculation of nursing personnel for intensive care stations". Krankenpflege (Frankf). 47(7-8):452-4. PMID: 8377453. Jul-Aug. 1993.
[21] . Cuthbert, MI. "Prediction, calculation and allocation of staff required for patient care". Aust Nurses J. 1983 Sep; 13(3):48-51. PMID: 6557809.
[22] . Smallwood, R.W., Sando, M.J., R.B., H. "Medical staff needed in a hospital to service anaesthesia and intensive care". Anaesth Intensive Care. 1981 Feb; 9(1):3-14. PMID: 7258596.
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