A discrete event simulation approach for reserving capacity for emergency patients in the radiology department

Background: Many hospitals in China experience large volumes of emergency department (ED) radiology patients, thereby lengthening the wait times for non-emergency radiology patients. We examine whether an emergency reservation policy which deals with stochastic arrivals of ED patients can shorten wait times, and what effect it has on patient and hospital related metrics. Methods: In this study, operations research models are used to develop an emergency reservation policy. First, we construct a discrete event simulation (DES) model based on the process of patients served by one computed tomography (CT) scanner at West China Hospital (WCH). Next, a newsvendor model is built to compute the daily reservation quantity for emergency patients. Based on the appointment scheduling rule and daily emergency reservation policies, the effects of the proposed policy on daily examination quantity, patient wait times, and equipment utilization are explicitly modeled. Finally, we evaluate the impact of different reservation policies on these system performance measures. Results: Our analysis indicates that reserving capacity for emergency patients greatly shortens the delay for non-emergency patients with an average 43.9% reduction in total wait times. The pre-model utilization and average post-model utilization are 99.3% and 98.5%, respectively. In addition, the comparison of different reservation policies shows that there is no significant difference between any two policies in terms of patients' wait times. Conclusions: Reserving proper capacity for emergency patients not only positively affects the patients' delay times, but also affects various aspects of the hospital. Our goal is to design a simple and implementable emergency reservation policy. DES proves to be an effective tool for studying the effects of proposed scenarios to optimize capacity allocation in radiology management.