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Title page for ETD etd-03152008-165339


Type of Document Dissertation
Author Levin, Scott R
Author's Email Address scott.r.levin@vanderbilt.edu
URN etd-03152008-165339
Title Applying Systems Engineering Tools to Measure and Improve Hospital-Based Health Care Delivery
Degree PhD
Department Biomedical Engineering
Advisory Committee
Advisor Name Title
Daniel J. France Committee Chair
Matthew B. Weinger Committee Member
Paul H. King Committee Member
Richard G. Shiavi Committee Member
Robert S. Dittus Committee Member
Robin R. Hemphill Committee Member
Keywords
  • discrete event simulation
  • emergency department crowding
Date of Defense 2008-01-10
Availability unrestricted
Abstract
Patient safety and emergency department functionality are compromised when inefficient coordination between hospital departments impedes ED patientsí access to inpatient cardiac care. The objective of this dissertation was to create a discrete event simulation model of hospital patient flow in order to determine how bed demand from competing cardiology admission sources affects ED patientsí access to inpatient cardiac care. The simulation employed survival analysis regression to model competition for inpatient cardiac beds and predict delays in ED patientsí access. The novel simulation strategy was used to demonstrate how altering outpatient schedules and creating informed bed management practices can optimize hospital capacity and improve ED patient access and how interventions designed to increase inpatient throughput or add capacity will have the most significant effect on highest priority patients.
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