کاهش زمان انتظار بیماران در فرآیند اورژانس بیمارستان آیت الله کاشانی اصفهان با استفاده از مدل شبیه سازی

  Introduction: In Emergency Departments (ED), seconds and minutes are vital for the patients. Therefore, a logical decision making is crucial to manage the patients’ waiting time. Simulation, a decision supporting technique, is used to analyze risk factors and strategies in decision making. The purpose of this research was to apply this method to reduce patients' waiting time in the ED at Ayatollah-Kashani Hospital.   Methods: The population of this applied- analytical study included the patients referred to the ED at Ayatollah-Kashani Hospital in Isfahan during May 2008. Having recognized the patients’ workflow, the researchers gathered the required data concerning the time of patients’ arrival and service delivery at various stations for 663 patients during 2 weeks. The data were used to design a simulation model for the ED using simul8 software. The validity of the model was verified through comparing the results obtained from the manual system with those from the simulation model which led to the formation of the finalized model.   Results: The results showed an increase in the waiting time when implementing alternatives 2, 9, 10 and 12 while a decrease was observed in other alternatives. In alternatives 6 and 13-17, the total waiting time decreased more than the other alternatives. The most amount of reduction was observed in alternative 15, so much so that the waiting time of receiving emergency services reduced from 112.19 to 99.24 minutes. This could be due to the placement of an intern student at Eye- Nose-Throat (ENT), Neurology, and Orthopedic stations which caused reduction in the waiting time from 38.89, 13.31 and 12.13 to 26.54, 6.58 and 5.98 minutes, respectively.   Conclusion: Since health care managers, especially in the ED, are mostly physicians not   experienced enough in statistical analysis, it is essential to provide them instruments with which they can readily achieve scientific approaches to reduce costs and patients’ waiting time. Applying various research methods such as simulation can satisfy these goals.