Evaluating processes and resource capacities in emergency services according to different triage scenarios: Simulation-based analysis and a model proposal

Emergency departments are healthcare units that serve on a 24/7 basis, characterized by irregular patient arrivals. As the most dynamic departments of the hospitals, they serve all kinds of patients from life-threatening cases to very simple complaints. The rapid increase in emergency department applications causes frequent overcrowding, causing disruptions in treatment, an increase in workload, a decrease in service quality, and administrative difficulties. As in all service sectors, effective management is extremely important in order to provide quality and timely service in health institutions. In order to avoid undesired results, it is important to see the possible consequences of managing in dynamic units such as emergency services before they are put into practice. Simulation appears to be a very useful method in terms of seeing and evaluating such managing results. This study was conducted in the emergency department of a public hospital, which proposes a new triage system in the emergency departments. Thus, it is aimed to provide better quality service to patients by reducing the frequent crowding. According to the proposed triage system, while reducing the waiting time of the patients in the emergency room and between the processes, appropriate personnel planning was made that would not endanger patient health and safety. According to the simulation data based on the proposed triage system, it was determined that there might be a 44.45% reduction in the duration of stay in the emerceny department and 83.44% in the waiting time in the first examination queue for the patients with the yellow triage code. In addition, with the new staff plan, it was foreseen that 20.24% earnings from doctor working hours, 30% from nurse working hours, 40% from medical secretary working hours and 50% from registration staff working hours were predicted.