计算机模拟:一种分析城市计划生育门诊病人与工作人员互动的方法

Anthony J. Alessandra , Ted E. Grazman , Ravi Parameswaran , Ugur Yavas
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摘要

当今城市医院某些部门的一个令人困惑的问题是他们无法有效地管理病人流量。在对我国东南部一个大城市的一家大型教学医院的计划生育诊所进行管理审查时发现了这一问题。一些工作站排起了长队,而另一些工作站却空无一人;一些诊所的工作人员总是忙着满足别人的时间需求,而另一些人则坐在那里聊天;病人等候区在某些时间人满为患,而在其他时间则完全没有病人。建立了计算机模拟模型,研究改变计划生育诊所目前的人员配置政策可能产生的影响,以及对减少所观察到的瓶颈的总体影响。在分析中测试了当前的操作程序以及其他七种替代方案。仿真模型是基于对医院记录的综合分析、对工作人员的访谈,以及最重要的对患者到达、等待排队、服务时间和离开时间的实际观察,用统计参数构建的。现在在医疗保健服务研究上投入的资金比以往任何时候都多。这项研究不仅为改善计划生育诊所的病人流量提供了建议,而且还表明,在卫生服务领域使用这种复杂的分析技术可以与已经在工业中证明的一样有价值,并产生同样多的协同效应。
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Computer simulation: A method for analyzing patient and staffing interaction within an urban outpatient family planning clinic

A perplexing problem today in certain departments within urban hospitals is their inability to manage the patient flow effectively. This problem was observed during a management review of a Family Planning Clinic of a large teaching hospital in a major city in the southeastern part of the country. Some work stations had long waiting lines while others were empty; some clinic employees were always rushing to meet demand for their time while others sat and chatted; and patient waiting areas were overcrowded at certain times while there was a complete absence of patients at other times.

A computer simulation model was developed to study the possible effects of changing the current staffing policies of the Family Planning Clinic and the overall effect on reducing the observed bottlenecks. Current operating procedures were tested along with seven other alternatives in the analysis.

The simulation model was constructed with statistical parameters based on a comprehensive analysis of hospital records, interviews with the staff, and, most importantly, actual observations of patient arrivals, waiting lines, service times, and exit times.

More dollars are now being spent in health care delivery research than ever before. This study not only offers recommendations for improved patient flow at the Family Planning Clinic, but also shows that the use of such sophisticated analytical techniques in the health delivery field can be just as valuable and evoke just as many synergistic effects as has already been demonstrated in industry.

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