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Perfect World Model of the EU

Perfect World Model of the EU. with Andrew Nelson, Kesh Baboolal , Jeff Griffiths, Cheryl Voake. Problem. Cardiff and Vale Health Board approached the OR Group within Cardiff School of Mathematics to help determine:.

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Perfect World Model of the EU

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  1. Perfect World Model of the EU with Andrew Nelson, KeshBaboolal, Jeff Griffiths, Cheryl Voake

  2. Problem Cardiff and Vale Health Board approached the OR Group within Cardiff School of Mathematics to help determine: • 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.

  3. EU Department Resus Majors MAU Resus Majors Paed. Minors A&E Paed. Majors SAU Minors Paeds. Minors GP Ref.

  4. 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

  5. Majors hourly arrival rate

  6. Majors Pathway EU Department Resus Majors MAU Resus Majors Paed. Minors A&E Paed. Majors SAU Minors Paeds. Minors GP Ref.

  7. GP Referral hourly arrival rate

  8. GP Referral Pathway EU Department Resus Majors MAU Resus Majors Paed. Minors A&E Paed. Majors SAU Minors Paeds. Minors GP Ref.

  9. Simulation Model Resus HDU TB MAU Minor Paed. SAU

  10. Different Staffing Patterns • Registrars, Consultants, Nurse Assessors • Clinical Decision Makers: 11 7 14 18 02 10 11 Members of Staff between 1800 and 0200. 7 Members of Staff between 0200 and 1000. 14 Members of Staff between 1000 and 1800.

  11. Different Staffing Patterns

  12. Closer Look at 8.6.11 • Reducing the number of TB, MAU and SAU beds:

  13. Conclusions • Not a perfect world: Service (To remove “blockage” ward needs to accommodate an arrival every 30 minutes)

  14. 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

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