perfect world model of the eu with andrew nelson, kesh baboolal, jeff griffiths, cheryl voake
TRANSCRIPT
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Perfect World Model of the EU
withAndrew Nelson, Kesh Baboolal, Jeff Griffiths, Cheryl Voake
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Problem
whether further investment in the emergency department was indeed warranted;
whether the allocation of resources within the emergency and assessment units could be improved;
whether capacity within the emergency department was being used to compensate for constraints beyond the emergency unit.
Cardiff and Vale Health Board approached the OR Group within Cardiff School of Mathematics to help determine:
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EU Department
A&E
MAU
SAU
Resus
Minors Paeds.
Majors
Majors
Resus
Paed. Minors
Paed.Majors
Minors
GP Ref.
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Demand patterns
3 Phases of the day: 1000-1800 1800-0200 0200-1000
3 Phases of the week: Monday Tue/Wed/Thu/Fri Sat/Sun
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Majors hourly arrival rate
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Majors Pathway
EU Department
A&E
MAU
SAU
Resus
Minors Paeds.
Majors
Majors
Resus
Paed. Minors
Paed.Majors
Minors
GP Ref.
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GP Referral hourly arrival rate
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GP Referral Pathway
EU Department
A&E
MAU
SAU
Resus
Minors Paeds.
Majors
Majors
Resus
Paed. Minors
Paed.Majors
Minors
GP Ref.
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Simulation ModelResus HDU
TB
Minor
Paed.
MAU
SAU
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Different Staffing Patterns
Registrars, Consultants, Nurse Assessors Clinical Decision Makers:
18 02 10
11 7 14
11 Members of Staff between 1800 and 0200.
7 Members of Staff between 0200 and 1000.
14 Members of Staff between 1000 and 1800.
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Different Staffing Patterns
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Closer Look at 8.6.11
Reducing the number of TB, MAU and SAU beds:
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Conclusions
Not a perfect world:
Service
(To remove “blockage” ward needs to accommodate an arrival every 30 minutes)
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Vile J, Gillard J, Harper PR and Knight VA (2012), “Forecasting Welsh Ambulance Demand
Using Singular Spectrum Analysis”. Journal of the Operational Research Society 63: 1556-1565.
Knight VA, Harper PR and Smith L (2012), “Ambulance Allocation for Maximal Survival with
Heterogeneous Outcome Measures”. OMEGA - The International Journal of Management
Science. 40: 918–926
Knight VA and Harper PR (2012), “Modelling Emergency Medical Services with Phase-type
Distributions”. Health Systems 1: 58-68
Baboolal K, Griffiths J, Knight VA, Nelson AV, Voake C and Williams JE. (2012), “How Efficient
can an Emergency Unit be? A Perfect World Model”. Emergency Medicine Journal. 29:972-977
Sahu SK, Baffour B, Harper PR, Minty JH and Sarran C (2013), “A Hierarchical Bayesian Model
for Improving Short-Term Forecasting of Hospital Demand by Including Meteorological
Information”. To appear in the Journal of the Royal Statistical Society, Series A.
www.profpaulharper.com www.vincent-knight.com