Abstract

RESTREPO-ZEA, Jairo Humberto; JAEN-POSADA, Juan Sebastián; ESPINAL PIEDRAHITA, Juan José  and  ZAPATA FLOREZ, Paula Andrea. Emergency Department Overcrowding: A Four-Hospital Analysis in Medellín and a Strategy Simulation. Rev. Gerenc. Polit. Salud [online]. 2018, vol.17, n.34, pp.130-144. ISSN 1657-7027.  https://doi.org/10.11144/javeriana.rgps17-34.ssua.

Medical emergency services can be overcrowded due to both external and internal service factors. This is evinced in the congestion, longer waits, and dissatisfaction by the users. To identify and simulate strategies for processing medical emergency requests in order to mitigate the overcrowding. An exploratory and analytical research was conducted based on the field work at four emergency rooms in hospitals of Medellín; simulation strategies were then proposed against the overcrowded service with system dynamics. The strategies included: to reorganize the sign-in, refer to other places those patient not requiring emergency services, implement fast-track services, and increase the inpatient capacity. The last one becomes the most effective strategy in the simulation. While the flow strategies can help to solve the service overcrowding due to internal causes as suggested in the literature, these strategies are limited in their scope. The required patient sign-in strategies as well as the patient discharge strategies are not easy-to-do in these emergency rooms. Overcrowding can be reduced by thinking of the hospital and the emergency room as two elements in a single system, so that the patient flow can be speeded up; the bed number for inpatients must be improved without overflowing the hospital capacity.

Keywords : medical emergencies; triage; access; overcrowding; hospital efficiency; system dynamics.

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