Insight diagram

Causal Loop Diagram of the Dynamics of Emergency Department Overcrowding

Emergency Room Patient Flow Complex CLD
Insight diagram
Simplest ED Model for Daily ED Performance with 1 ED area rather than 2 in IM-10571. Currently runs over a weekend and calibrated roughly to Weekend Data. ED completion rate may be better as a converter.
Clone of ED Flows without Separate Areas
Insight diagram

Rich picture version of published simple model representation described as a capacitated processing model, modified to separate Patient Flow from workflow.

Clone of ED Resilience SD rich picture
Insight diagram
NEAT Project WIP Narrow view of ED only. See IM-6167 for the widest view and IM-6913 for Task Interactions within the ED
NEAT Impact on ED only Simplest Model
Insight diagram
Simulation model of the WIP Conceptual map IM-7671 of initial scope of the effects of the ED 4 hour rule based on June WA Teleconference and IM-8221. See also the conceptual maps of addition of indirect effects at IM-7775 and the potential wider context map in IM-6167
Clone of Initial Simulation Model for NEAT 4 hour rule Project
Insight diagram
Clone of IM-11079 ED Model for Daily ED Performance with 2 areas again, as in the previous IM-10571. Focus on shift performance by Specialist.
Clone of ED Flows with Acute and FastTrack Areas
Insight diagram
Simplest ED Model for Daily ED Performance with 1 ED area rather than 2 in IM-10571. Currently runs over a weekend and calibrated roughly to Weekend Data.Ward net discharges are extended in IM-12414. The Master Version of this, with the story added is at IM-11936
Clone of ED Flows without Separate Areas
Insight diagram

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

Clone of ED flows by triage categories with hourly arrival
Insight diagram

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

Clone of Emergency Department Simple Wait View 1
Insight diagram
Simplest ED Model for Daily ED Performance with 1 ED area rather than 2 in IM-10571. Currently runs over a weekend and calibrated roughly to Weekend Data. ED completion rate may be better as a converter.
Clone of #11079 ED Flows without Separate Areas
Insight diagram

Causal loop diagram of the dynamics of emergency and elective admissions competing for vacant ward beds in a hospital. From

Lane, David C. and Monefeldt, C. and Rosenhead, Jonathan (2000) Looking in the wrong place for healthcare improvements: a system dynamics study of an accident and emergency department.  Journal of the Operational Research Society, 51 (5). pp. 518-531. ISSN 0160-5682 

See IM-7981 for Simulation Model

Clone of Hospital Emergency and Elective Admission Interaction CLD
Insight diagram
Physician agents interacting with delegate agents for emergency department assessment diagnosis and treatment. From BMC paper May 2013, combining figs 1 and 2
Clone of ED Physician Delegation Hybrid Model
Insight diagram

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.  

Clone of Emergency Room Patient Flow Model 2 with Treatment Spaces
Insight diagram

Simulation model version of IM-398 CLD (which lists the reference).The dynamics of emergency and elective admissions competing for vacant ward beds in a hospital. Here Bed Capacity is a fixed parameter.  For discharge dynamics see IM-14124. For an adjusted bed capacity stock see IM-14144.For backlog and services see IM-8382

Clone of Clone of Hospital Emergency and Elective Admission Interaction Simulation 1
Insight diagram
Click +View Story on Bottom Left to unfold his wide view of Emergency care patient flows IM-6072 used as context to add confounders and potential indirect effects. See also IM-1010 for hospital fixes that fail, wiki for general Systems Archetypes and wiki for Leverage Points (There is also a health leverage points WIP wiki page)
Clone of Confounding Interventions and Indirect Effects of the Four Hour Rule
Insight diagram

Extension of IM-7981 with dynamics of daily ward discharges and did not waits. For an adjusted bed capacity stock see IM-14144.For backlog and services see IM-8382

Clone of Hospital Emergency and Elective Admission Interaction Simulation 2
Insight diagram
Simplest ED Model for Daily ED Performance with 1 ED area rather than 2 in IM-10571. Currently runs over a weekend and calibrated roughly to Weekend Data.Ward net discharges are extended in IM-12414. The Master Version of this, with the story added is at IM-11936
Clone of Clone of ED Flows without Separate Areas
Insight diagram

Simulation model version of IM-398 CLD (which lists the reference).The dynamics of emergency and elective admissions competing for vacant ward beds in a hospital. Here Bed Capacity is a fixed parameter.  For discharge dynamics see IM-14124. For an adjusted bed capacity stock see IM-14144.For backlog and services see IM-8382

Clone of Hospital Emergency and Elective Admission Interaction Simulation 1
Insight diagram
Simulation model of the WIP Conceptual map IM-7671 of initial scope of the effects of the ED 4 hour rule based on June WA Teleconference and IM-8221. See also the conceptual maps of addition of indirect effects at IM-7775 and the potential wider context map in IM-6167
Clone of Initial Simulation Model for NEAT 4 hour rule Project
Insight diagram

Extension of IM-7981 with dynamics of daily ward discharges and did not waits. For an adjusted bed capacity stock see IM-14144.For backlog and services see IM-8382

Clone of Hospital Emergency and Elective Admission Interaction Simulation 2
Insight diagram
Backup of IM-11079 before shared editing for merging storytelling. Simplest ED Model for Daily ED Performance with 1 ED area rather than 2 in IM-10571. Currently runs over a weekend and calibrated roughly to Weekend Data.Ward net discharges are extended in IM-12414
Clone of ED Flows without Separate Areas
Insight diagram

Dynamics of Emergency Room Crowding with treatment spaces and boarders waiting for ward beds (access block if the wait is too long).

Clone of Clone of Clone of Emergency Department Patient Flow Model 3 with Boarders
Insight diagram

Causal Loop Diagram of the Dynamics of Emergency Department Crowding Initial View from the waiting room 

Clone of Emergency Department Simple Wait View CLD 1
Insight diagram


Final ED model