ED computer simulations don't focus enough on physician relationships

Currently, computer simulation studies of emergency departments are patient-driven, using physicians in a way that focuses largely on their interactions with patients alone. In actual emergency departments, however, physicians are busy supervising different delegates, such as residents, physician assistants and nurses.

In a study published online this week in BMC Medical Informatics and Decision Making, researchers set out to present an alternative simulation approach, where physicians and their delegates in the ED are "modeled as pseudo-agents in a discrete event simulation." They then compared the new model with the traditional approach.

In the new approach, physician utilization increased from 23 to 41 percent, while delegate utilization increased from 56 to 71 percent. 
The study described the ED as a "complex environment" that involves varying interactions among patients, staff and other ED workers. Relationships between physicians and their delegates are important in the ED process, the study's authors said, especially in teaching hospitals.

"Neglecting these relationships could lead to inefficient resource allocation due to inaccurate estimates of physician and delegate time spent on patient related activities and length of stay," the researchers said. "In light of these results, future modeling of the ED setting should incorporate interaction between physician and delegate by modeling them as agents."

In late March, FierceHealthIT reported on various healthcare organizations and practitioners investing in simulation centers to review and perfect procedures, such as MetroHealth Medical Center, which poured $450,000 into development of a new simulation center.

To learn more:
- read the study

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