Improving the efficiency of a hospital ED according to lean management principles through system dynamics and discrete event simulation combined with quantitative methods

Abstract

The Emergency Department of a Hospital has both exogenous and endogenous management problems. The first ones are about the relationship with the other Departments, for which the Emergency Department is a noise element on the planned activities, as it generates an unplanned beds occupation. The second ones strictly depend on the Department organizational model. After an intensive study on the Emergency Department of a medium size Italian Hospital, the Authors illustrate how, through the use of Lean Management philosophy combined with quantitative methods, the current situation can be analyzed and they propose a set of corrective actions. These allow to increase the system efficiency and to reduce both the number of the waiting patients and their stay. At the same time, the activities are reallocated to the staff, improving their utilization coefficient. So the Management can assess the validity of the proposed strategies before their eventual implementation in the field.