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A Simulation Model for Bioterrorism Preparedness in An Emergency Room

A Simulation Model for Bioterrorism Preparedness in An Emergency Room. Lisa Patvivatsiri Department of Industrial Engineering Texas Tech University Presented by Hoang Bui Computer Science Department Midwestern State University. Overview. Introduction Why uses simulation?

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A Simulation Model for Bioterrorism Preparedness in An Emergency Room

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  1. A Simulation Model for Bioterrorism Preparedness in An Emergency Room Lisa Patvivatsiri Department of Industrial Engineering Texas Tech University Presented by Hoang Bui Computer Science Department Midwestern State University

  2. Overview • Introduction • Why uses simulation? • Emergency room process • Simulation model • Experimental scenario analysis • Question

  3. Introduction • Bioterrorism threats after 9/11/2001 • Requirement for a quick response plan • Lack of prior knowledge

  4. Why uses simulation? • Validity • Real-time processing • User interface • Flexibility • Easy to use

  5. Emergency room process • Medium size hospital in Lubbock, Texas • Some definitions: • Pod: a section in the ER • Pod A: 19 beds • Pod B: 12 beds • Pod C: 10 beds • 19 additional beds in hall way • Severe patients • Serious injured patients • Walking-wounded patients • Charge nurses

  6. Emergency room process

  7. Arrival process • Walk-In Patient • 723 patients per week • IAT = 13.94 minutes • Ambulance • 5 patients per day • IAT = 288 minutes • Helicopter • 1 per week • IAT = 10080 minutes

  8. Triage and Pod assignment • Walk-In patient: • Go in to triage process • 4 triage nurses • Service time: triangular distribution(20,23,25) • Send to Pod A, B or C • Ambulance and Helicopter patient: • Send to Pod A

  9. Treatment process • Resource: • Pod C: 11:00AM – 11:00 PM • 6 treatment nurses per pod • 3 shared medical doctors • Bedside registration by a charge nurse • Initial assessment by a treatment nurse • MD evaluation • 86 of 723 patients require further lab test

  10. Treatment process

  11. Simulation model

  12. Simulation model • Software: • Flexsim 2.6 • Input and output spreadsheet in Excel 2003 • Assumption: • Testing equipment is not included • Testing time is triangular distribution(95,156,192) • Doctors and nurses in Pod C work overtime • A patient releases his bed only when leaving

  13. Simulation model • Validation and Verification • Meet frequently with E.R. director and staff • Data collected by E.R. supervisor • 7 days warm-up follow by 30 days run • 10 replications • Average time in system:202.42 minutes(simulation) vs. 207.42 minutes (actual)

  14. Experimental scenario analysis • Outbreak of contagious disease: • 432 people are infected during 72 hours • Addition patients every 10 minutes during 1st 72 hours

  15. Experimental scenario analysis

  16. Experimental scenario analysis • Proposed new strategy • Move 10 beds from Pod A to Pod B, and 12 beds in the hallway to Pod C • Move 2 treatment nurses from Pod A to Pod C • Add 4 treatment nurses to Pod B • Add 2 more MD

  17. Experimental scenario analysis

  18. Experimental scenario analysis

  19. Experimental scenario analysis

  20. Questions

  21. Reference • A Simulation Model for Bioterrorism Preparedness in An Emergency Room by Lisa Patvivatsiri, In Proceedings of the 2006 Winter Simulation Conference.

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