Measuring effective capacity in an emergency department
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 21 March 2016
Abstract
Purpose
The purpose of this paper is to show how elements from queueing theory can be used to obtain objective measures of effective capacity in the triage function at Skaraborg Hospital in Sweden without direct observation of the function itself.
Design/methodology/approach
Approximately 30,000 patients arrived to the emergency department at Skaraborg Hospital in Sweden during 2011. The exact time of arrival and the exact time of triage were recorded for each patient on an individual level. Basic queueing theory uses arrival rates and system capacity measures to derive average queueing times. The authors use the theoretical relation between these three measures to derive system capacity measures based on observed arrival rates and observed average queueing times.
Findings
The effective capacity in the triage process is not a linear function of the number of nurses. However, the management of capacity seems well adapted to the actual demand, even though service levels vary substantially during the day and night.
Originality/value
This paper uses elements from queueing theory in an innovative way to measure the effective capacity of a service process without direct observation, thereby also avoiding the potential risk of the Hawthorne effect.
Keywords
Acknowledgements
The authors wish to thank Mattias Sundén for mathematical assistance.
Citation
Lantz, B. and Rosén, P. (2016), "Measuring effective capacity in an emergency department", Journal of Health Organization and Management, Vol. 30 No. 1, pp. 73-84. https://doi.org/10.1108/JHOM-05-2014-0074
Publisher
:Emerald Group Publishing Limited
Copyright © 2016, Emerald Group Publishing Limited