Pairing emergency severity index5-level triage data with computer aided system design to improve emergency department access and throughput

Patient waiting times and service quality problems characterize emergency departments worldwide. The purpose of this research is to develop a reliable decision support system using the Emergency Severity Index (ESI(C)) triage method to drive improvements in the care delivery process, as part of a hospital Emergency Care Delivery System. Models were developed using first a relatively low fidelity software, ProcessModel, and then in Arena, a relatively high fidelity simulation software, to test new proposals for service delivery improvements in an academic ED in York Hospital, Pennsylvania, where the ESI(C) triage system has been implemented. This paper pairs the case mix derived from ESI(C) triage with simulation to support resource deployment to improve service metrics and support strategic decision making in academic EDs. The lessons learned could be re-analyzed in a simulation model more representative of a non-academic (regular hospital) ED that implements ESI(C) five level triage.