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A Simulation Model for Bioterrorism Preparedness in An Emergency Room

Explore a simulation model for bioterrorism preparedness in an emergency room setting, analyzing various scenarios, strategies, and response plans for efficient and effective emergency response.

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A Simulation Model for Bioterrorism Preparedness in An Emergency Room

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  1. A Simulation Model for Bioterrorism Preparedness in An Emergency Room Lisa Patvivatsiri Department of Industrial Engineering Texas Tech University Presented by Hoang Bui Computer Science Department Midwestern State University

  2. Overview • Introduction • Why uses simulation? • Emergency room process • Simulation model • Experimental scenario analysis • Question

  3. Introduction • Bioterrorism threats after 9/11/2001 • Requirement for a quick response plan • Lack of prior knowledge

  4. Why uses simulation? • Validity • Real-time processing • User interface • Flexibility • Easy to use

  5. Emergency room process • Medium size hospital in Lubbock, Texas • Some definitions: • Pod: a section in the ER • Pod A: 19 beds • Pod B: 12 beds • Pod C: 10 beds • 19 additional beds in hall way • Severe patients • Serious injured patients • Walking-wounded patients • Charge nurses

  6. Emergency room process

  7. Arrival process • Walk-In Patient • 723 patients per week • IAT = 13.94 minutes • Ambulance • 5 patients per day • IAT = 288 minutes • Helicopter • 1 per week • IAT = 10080 minutes

  8. Triage and Pod assignment • Walk-In patient: • Go in to triage process • 4 triage nurses • Service time: triangular distribution(20,23,25) • Send to Pod A, B or C • Ambulance and Helicopter patient: • Send to Pod A

  9. Treatment process • Resource: • Pod C: 11:00AM – 11:00 PM • 6 treatment nurses per pod • 3 shared medical doctors • Bedside registration by a charge nurse • Initial assessment by a treatment nurse • MD evaluation • 86 of 723 patients require further lab test

  10. Treatment process

  11. Simulation model

  12. Simulation model • Software: • Flexsim 2.6 • Input and output spreadsheet in Excel 2003 • Assumption: • Testing equipment is not included • Testing time is triangular distribution(95,156,192) • Doctors and nurses in Pod C work overtime • A patient releases his bed only when leaving

  13. Simulation model • Validation and Verification • Meet frequently with E.R. director and staff • Data collected by E.R. supervisor • 7 days warm-up follow by 30 days run • 10 replications • Average time in system:202.42 minutes(simulation) vs. 207.42 minutes (actual)

  14. Experimental scenario analysis • Outbreak of contagious disease: • 432 people are infected during 72 hours • Addition patients every 10 minutes during 1st 72 hours

  15. Experimental scenario analysis

  16. Experimental scenario analysis • Proposed new strategy • Move 10 beds from Pod A to Pod B, and 12 beds in the hallway to Pod C • Move 2 treatment nurses from Pod A to Pod C • Add 4 treatment nurses to Pod B • Add 2 more MD

  17. Experimental scenario analysis

  18. Experimental scenario analysis

  19. Experimental scenario analysis

  20. Questions

  21. Reference • A Simulation Model for Bioterrorism Preparedness in An Emergency Room by Lisa Patvivatsiri, In Proceedings of the 2006 Winter Simulation Conference.

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