Modelling accident and emergency department processes
- CLAHRC Wessex Data Science Hub - Dr Tom Monks
- Academic Health Science Network Centre for Implementation Science
- Queen Alexandra Hospital, Portsmouth
The performance of accident and emergency departments (ED) in the United Kingdom is measured by the four hour waiting time target. Queen Alexandra Hospital (QAH), Portsmouth is constantly improving their processes in order to increase their performance against the target. Running live experiments of new processes is difficult in a pressured ED and effects are often difficult to discern due to the inherent day to day variations in patients and hospital pressures.
CLAHRC Wessex and the Data Science team is working with the AHSN Centre for Implementation Science and QAH to develop simulation models of QAH’s accident and emergency department processes and associated hospital functions. The models mimic the flow of patients through the ED from arrival by ambulance, through treatment by a doctor, undergoing diagnostics, to admission into a hospital bed or discharge and predicts all of the waiting times for resources. The model accurately captures the patterns of arrivals and across a working day and week and importantly accounts for the unpredictable variability seen in when patients arrives and how long it can take to process them.
The models provide a way for QAH to ask ‘what-if’ we operated the ED differently – how would the implemented changes affect performance? The models can objectively compare what proportion of patients spend less than 4 hours in ED in the new option to how the ED currently operates.