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Looking in the wrong place for healthcare improvements: a system dynamics study of an accident and emergency department

Lane, David C., Monefeldt, Camilla and Rosenhead, Jonathan (2000) Looking in the wrong place for healthcare improvements: a system dynamics study of an accident and emergency department. Journal of the Operational Research Society, 51 (5). pp. 518-531. ISSN 0160-5682

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Abstract

Accident and Emergency (A&E) units provide a route for patients requiring urgent admission to acute hospitals. Public concern over long waiting times for admissions motivated this study, whose aim is to explore the factors which contribute to such delays. The paper discusses the formulation and calibration of a system dynamics model of the interaction of demand pattern, A&E resource deployment, other hospital processes and bed numbers; and the outputs of policy analysis runs of the model which vary a number of the key parameters. Two significant findings have policy implications. One is that while some delays to patients are unavoidable, reductions can be achieved by selective augmentation of resources within, and relating to, the A&E unit. The second is that reductions in bed numbers do not increase waiting times for emergency admissions, their effect instead being to increase sharply the number of cancellations of admissions for elective surgery. This suggests that basing A&E policy solely on any single criterion will merely succeed in transferring the effects of a resource deficit to a different patient group.

Item Type: Article
Official URL: http://www.palgrave-journals.com/jors/index.html
Additional Information: © 2000 Operational Research Society
Library of Congress subject classification: R Medicine > RA Public aspects of medicine
Sets: Research centres and groups > Managerial Economics and Strategy Group
Research centres and groups > Management Science Group
Rights: http://www.lse.ac.uk/library/usingTheLibrary/academicSupport/OA/depositYourResearch.aspx
Date Deposited: 15 Aug 2008 12:22
URL: http://eprints.lse.ac.uk/20846/

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