Emergency medicine: an operations management view.
Emergency medicine: an operations management view.
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急诊医学：运营管理观点。
DOI：
10.1111/j.1553-2712.2011.01226.x
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Pines,JesseM
中科院分区：
文献类型：
--
作者：
Soremekun,OlanA;Terwiesch,Christian;Pines,JesseM
学术急救医学2011; 18：1262-1268 © 2011由学术急救医学协会摘要运营管理（OM）是理解和改进业务流程的科学。对于急诊科（艾德），OM原则可用于减少和缓解拥挤的影响。OM的一个基本原则是等待时间公式，鉴于等待时间是以患者为中心的急诊护理的基础，该公式在艾德中具有明确的含义。等待时间公式包括活动时间（完成一个流程需要多长时间）、利用率（员工等特定资源的工作时间比例）和两个变化度量：患者到达间隔时间的变化和患者处理时间的变化。了解等待时间公式很重要，因为它提供了可以减少等待时间和住院时间的基本参数。适用于艾德的另一个有用的OM原则是有效边界。有效边界比较了ED在两个方面的表现：响应性（即，1/等待时间）和利用率。有些执行主任可能处于“前沿”，在其给定的利用率下最大限度地提高其响应能力。然而，大多数ED可能有机会走向前沿。增加能力是一种沿着边界的运动，并真正走向边界（即，提高固定容量的响应能力），我们阐明了三种可能的选择：消除浪费、减少可变性或增加灵活性。当概念化艾德拥挤干预措施时，这些是要考虑的主要策略。
ACADEMIC EMERGENCY MEDICINE 2011; 18:1262–1268 © 2011 by the Society for Academic Emergency MedicineAbstractOperations management (OM) is the science of understanding and improving business processes. For the emergency department (ED), OM principles can be used to reduce and alleviate the effects of crowding. A fundamental principle of OM is the waiting time formula, which has clear implications in the ED given that waiting time is fundamental to patient‐centered emergency care. The waiting time formula consists of the activity time (how long it takes to complete a process), the utilization rate (the proportion of time a particular resource such a staff is working), and two measures of variation: the variation in patient interarrival times and the variation in patient processing times. Understanding the waiting time formula is important because it presents the fundamental parameters that can be managed to reduce waiting times and length of stay. An additional useful OM principle that is applicable to the ED is the efficient frontier. The efficient frontier compares the performance of EDs with respect to two dimensions: responsiveness (i.e., 1/wait time) and utilization rates. Some EDs may be “on the frontier,” maximizing their responsiveness at their given utilization rates. However, most EDs likely have opportunities to move toward the frontier. Increasing capacity is a movement along the frontier and to truly move toward the frontier (i.e., improving responsiveness at a fixed capacity), we articulate three possible options: eliminating waste, reducing variability, or increasing flexibility. When conceptualizing ED crowding interventions, these are the major strategies to consider.
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