به‎کارگیری شبیه‎سازی گسسته پیشامد و تحلیل پوششی داده‎ها به‎منظور بهبود عملکرد اورژانس بیمارستان

نوع مقاله: مقاله علمی پژوهشی

نویسندگان

1 استادیار، گروه مهندسی صنایع، دانشکده فنی فومن، پردیس دانشکده‌های فنی دانشگاه تهران، ایران.

2 دانشجوی کارشناسی ارشد، گروه مهندسی صنایع، دانشکده مهندسی صنایع، پردیس دانشکده‌های فنی، دانشگاه تهران، ایران.

3 دانشیار، گروه مدیریت صنعتی، دانشکده مدیریت دانشگاه تهران، تهران، ایران

چکیده

هدف: در این مطالعه از شبیهﺳﺎزی گسسته پیشامد برای بهبود عملکرد اورژانس بیمارستان با هدف کاهش زمان انتظار بیماران و بهینهﻳﺎبی منابع استفاده شده است.
روش: نخست بر اساس فرایند جریان بیماران در اورژانس بیمارستان، با استفاده از نرم‎افزار ARENA یک مدل شبیهﺳﺎزی توسعه داده شد، سپس این مدل شبیهﺳﺎزی برای هر سناریوی شدنی که شامل تعداد پزشک عمومی، متخصص طب اورژانس، پرستاران بخش تحت نظر، بخش درمان حاد، تخت تزریقات، تخت بخش تحت نظر و بخش درمان حاد است، 180 بار به اجرا درآمد. در گام بعد، دو روش رتبه‎بندی تحلیل پوششی داده‎ها برای رتبه‎بندی سناریوها به کار گرفته شد.
یافته‎ها: رتبه‎بندی روﺵهای تحلیل پوششی داده‎ها نشان داد که در هر دو روش، سناریوی 39 بهترین انتخاب است. برای تعیین وجود همبستگی میان نتایج روشﻫﺎی رتبهﺑﻨﺪی نیز از آزمونﻫﺎی ناپارامتری اسپیرمن ـ رو و کندال ـ تاو استفاده شد که نتایج آنها به‎ترتیب 93/0 و 81/0 به‎دست آمد. این نتایج گویای وجود همبستگی میان روﺵهای رتبهﺑﻨﺪی تحلیل پوششی داده‎هاست.
نتیجه‎گیری: نتایج مطالعه نشان داد که در هر دو روش رتبه‎بندی تحلیل پوششی داده‎ها، سناریو 39 بهترین سناریو در میان 44 سناریوی شدنی تعریف شده است. یعنی باید 2 پزشک عمومی، 1 متخصص طب اورژانس، 16 پرستاران در بخش تحت نظر، 5 پرستار در بخش درمان حاد، 2 تخت در تزریقات، 22 تخت در بخش تحت نظر و 16 تخت در بخش درمان حاد به‎کار گرفته شود.

کلیدواژه‌ها


عنوان مقاله [English]

Discrete Event Simulation and Data Envelopment Analysis to Improve the Performance of Hospital Emergency Department

نویسندگان [English]

  • Salman Nazari Shikouhi 1
  • Amir Yaghoobi 2
  • Mohammad Reza Taghizadeh Yazdi 3
1 Assistant Prof., Department of Industrial Engineering, Fouman Faculty of Engineering, College of Engineering, University of Tehran, Iran
2 MSc., Department of Industrial Engineering, College of Engineering, Campus Technical Schools, University of Tehran, Tehran, Iran
3 Associate Prof., Department of Industrial Management, Faculty of Management, University of Tehran, Tehran, Iran
چکیده [English]

Objective: This study applies a discrete event simulation to improve the performance of hospital emergency department in order to reduce the waiting time for patients and optimize the resources.
Methods: First, a simulation model is developed based on flow of patients in an emergency department using ARENA software; then, the simulation model is run 180 times for any feasible scenario including some physicians, emergency medicine specialists, nurses, acute phase cure unit, injection unit, supervised ward, and ICU unit. In the next step, two data envelopment analysis methods are used for ranking the scenarios.
Results: Ranking of DEA methods showed that the scenario number 39 is the best choice in both methods. Non-parametric Spearman-Row and Kendal-Tau tests were used to determine the correlation among the results of ranking methods. The results of the two tests (0.93 and 0.81, respectively) indicated a significant correlation among DEA ranking methods.
Conclusion: The results of case study showed that the scenario 39 is the best scenario among all the 44 feasible scenarios defined in both DEA methods; that is, there should be 2 general physicians, 1 emergency medicine specialist, 16 nurses in the supervised ward, 5 nurses in the acute care unit, 2 beds in the injection room, 22 beds in the supervised ward and 16 beds in the acute care unit.

کلیدواژه‌ها [English]

  • Discrete event simulation
  • Data Envelopment Analysis
  • Hospital Emergency
  • Patient waiting time
  • Nonparametric correlation tests

براتلو، علیرضا؛ رحمتی، فرهاد؛ فروزانفر، محمدمهدی؛‎هاشمی، بهروز؛ معتمدی، مریم؛ صفری، سعید (1394). ارزیابی شاخص‎های عملکرد بخش اورژانس. مجله پزشکی اورژانس ایران، 2(1)، 33-38.

 

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