Abstract
In this study, we investigate the effect of a new boarding policy - short stay observation ward (SSOW), on the overcrowding efficiency in emergency department (ED). The decision variables are no. of short stay beds for least acuity ED patients. The performance measurements used are national emergency department overcrowding score (NEDOCS). Discrete event simulation (DES) is used as a analysis tool to evaluate the strategy. Also, common random number (CRN) technique is applied to enhance the simulation precision. The DES model was based on a census of 6 months’ patients who were treated in the ED of the National Taiwan University Hospital Yunlin Branch. Our results show that the new short-stay boarding significantly impacts the NEDOCS score and this analysis provides a quantification of the impact of boarding on emergency department patient crowding. Moreover, the proportion of the severer days (NEDOCS score≥ 100) would decrease from 77% to 57% in the best case when the SSOW increased from 0 to 10; and decrease from 57% to 52% in the best case when the SSOW increased from 10 to 16. Our study outperforms the previous work in that we provide thorough DES study and a implementable strategy (SSOW).