A stock flow structure used to show the unit of analysis, scope of study and context of the ED Four hour rule project, cloned from im-399 monthly flows

This is a launchpad for patient flow insights for flows through the emergency department and hospital, including the broader community context. It also includes links to other insights relevant to ED flow improvement.

Dynamics of Emergency Department Crowding Initial Simplest Simulation of the View from the waiting room. Start of a simple introductory series which proceeds to IM-338  A simple CLD is at IM-340

Hourly arrival pattern added to IM-663 A work in progress model for ED daily average flows based on reported statistics by triage category with all triage categories aggregated. Based on a hospital performance report from  http://www.bhi.nsw.gov.au/publications/hospital_quarterly_3 

See IM-8221 for Triage splits WIP

Coping but not coping in health and social care: masking the reality of running organisations beyond safe design capacity. From Eric Wolstenholme Syst. Dyn. Rev. 23, 371–389, (2007) abstract See IM-1008 for a stock flow version. Click the +View Story feature at the bottom left.

Concept map of patient flow through ED

A work in progress model for ED hourly arrival flows based on reported statistics by triage category with individual triage categories dis-aggregated using vectors. Based on a hospital performance report from  http://www.bhi.nsw.gov.au/publications/hospital_quarterly_3 

Split of IM-2166

WIP Ideas. Replaced by IM-14124 and IM-14414 Ideas here focus on Additional adjusted stock of Bed Capacity version of IM-7981 .The dynamics of emergency and elective admissions competing for vacant ward beds in a hospital. 

Extension of IM-14124 with an adjusted bed capacity stock. For backlog and services see IM-8382

Dynamics of Emergency Department Crowding Initial View from the waiting room. Follows from IM-369 Sim and IM-340 CLD. Proceed to IM-349 

Based on combining IM-7670  with IM-7671 (WIP based on June WA Teleconference) plus indirect effects

WIP Conceptual map of initial scope of the effects of the ED 4 hour rule based on June WA Teleconference. See also the addition of unintended consequences at IM-7775 and the potential wider context map in IM-6167. For a simulation see IM-8237

Flows between acute hospital and aged care for older people. See IM-1012 for a simpler version

Dynamics of Emergency Room Crowding a simple uncalibrated simulation which includes Wards and some simple internal ED feedback effects

WIP based on Choice modelling and Mark Paich's Book and NZ work focus on Pre-ED Presentation choices, with ED and Post-ED care. Extended based on IM-998 4 hour rule context. Can be replicated to add interventions, as in IM-6167. See IM-9178 for Addition of After hours 'as is' and 'to be' flow models for Medicare Locals

A general model of flows between hospital and the community with workshop elements. See also IM-3200 for focus on frequent presenters with mental health issues

WIP detail of ED Clinical processes with focus on Stabilising and Deciding how to Admit or Discharge safely, the Disposition decision. For more aggregated views see IM-8237 for flows and IM-6913 for Physician Delegate Agent Interactions

A  Medical Imaging view of Patient Flows through ED Imaging Workup from IM-374 , now modified by the Emergency Department's internal and external review procedures.

Dynamics of Emergency Room Crowding with treatment spaces. Here we investigate the effect of constrained spaces and ignore any changes in treatment time or staffing effects. Many of the consequences occur before treatment with potential arrivals being turned away and arrivals leaving without being treated.  

Published (Robert Wears) simple model representation described as a capacitated processing model, modified to separate Patient Flow from workflow. See also IM-8382 for more recent model

WIP for Whole of Hospital Program. Provides Context and Detail for Hospital Timeline Study IM-9382

Simple exposition of going solid article by Cook and Rasmussen 2005 after reading p156 section 4.1 of Modelling in Healthcare by CSMG See also Resilience Cs IM

See reference in diagram notes. WIP for Environment part of primary care regional model. GP centric calibration by JPS at IM-14117 See also IM-3126 for Regional Health Service Use Context

WIP for regional integration based on NHPA and IHPA activities in Australia