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Evaluation of Ambulance DiversionHuang, Chung-Yeh 10 February 2012 (has links)
The problem of overcrowding is one of the serious issues that almost every emergency department (ED) in Taiwan has to face on daily basis. ED crowding results in adverse medical outcomes, decline in quality of care, and lack of the ability to provide instant medical care. One of the viable (but not necessarily preferable) solutions to ED overcrowding is ambulance diversion (AD). That is, ambulances would bypass the ED¡¦s unable to provide emergency medical service, and send patients to another emergency department. In many medical systems, ambulance diversion is being seen as a standard operating procedure, whose effectiveness needs to be carefully studied before making a sound policy.
In this research, an input-throughput-output simulation model is proposed for simulating ED operation. A computer simulation program is developed based on this model to evaluate various AD initiating criteria, patient-blocking rules, and AD intervals. The crowdedness index, the patient waiting time for service, and the percentage of adverse patients were assessed to determine the impact of various AD policies. By appropriate parameter settings, this simulation model can represent medical resource providers of different scales. The results we obtained may offer insights for making effective AD policies.
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