NDLI: Discrete simulation application-scheduling staff for the emergency room

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Why simulation works

Simulation for decision making: an introduction

Parallel discrete event simulation

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Statistical issues in a general-purpose simulation modeling language

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Analysis of simulation data using sandie

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Simulation sensitivity analysis using frequency domain experiments

Likelihood ratio derviative estimators for stochastic systems

Derivative estimates from discontinuous realizations: smoothing techniques

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Using computer simulation to optimize flexible manufacturing systems design

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Experimental design issues for large scale simulation models

Implementation of quasi-random generators and their use in discrete event simulation

A flexible method for estimating inverse distribution functions in simulation experiments

Response surface analysis of stochastic network performance

Optimization using common random numbers, control variates and multiple comparisons with the best

Variance reduction of quantile estimates via nonlinear control

Augmenting linear control variates using transformations

Random number generation on parallel processors

Using linear congruential generators for parallel random number generation

About polynomial-time “unpredictable” generators

Mathematical aspects of various methods for sampling from classical distributions

Ratio of uniforms as a convenient method for sampling from classical discrete distributions

Inverse-transformation algorithms for some common stochastic processes

Monte Carlo simulation of complex system mission reliability

Large deviations theory techniques in Monte Carlo simulation

Quick simulation of rare events in networks

Multivariate inferences for regenerative simulations to a specified precision level

A principal components model of simulation structure

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Verification and validation: a consultant's perspective

Guidelines for selecting and using simulation model verification techniques

Simulating hybrid connectionist architectures

Simulation system for the control of manufacturing lines

The role of knowledge management in hierarchical model development

Object oriented toolkits for simulation program generators

Olympus: an interactive simulation system

Animating simulations in RESQME

Distributed simulation using hierarchical rollback

Rollback sometimes works...if filtered

Adaptive distribution of model components via congestion measures

Alternative modeling perspectives: finding the creative spark

Developing analytic models based on simulation results

a common programming structure for Bryant-Chandy-Misra, time-warp, and sequential simulators

Comparative analyses of parallel simulation protocols

Efficient aggregation of multiple PLs in distributed memory parallel simulations

How technology limits simulation methodology (panel)

A logic for simulating discontinous systems

Neural network models in simulation: a comparison with traditional modeling approaches

A comparison of selected conceptual frameworks for simulation modeling

Marked event method in discrete event simulation

On analyzing events to estimate the possible speedup of parallel discrete event simulation

Simulation graph duality: a world view transformation for simple queueing models

Parallel simulation: practice: contrasting distributed simulation with parallel replication: a case study of a queuing simulation on a network of transputers

Experience with concurrent simulation

Limitation of optimism in the time warp operating system

WATMIMS JIT/KANBAN benchmark summary and recommendations

A visual simulation model of a workstation in a rolling mill facility

Using simulation to explore potential improvements in an existing automated assembly system

Module modeling and economic optimization for large-scale AS/RS

AS/RS amd warehouse modeling

A modular structure for a highly detailed model of semiconductor manufacturing

Rapid modeling: in the design of a new PCB manufacturing system

Combining software engineering principles with discrete event simulation

Integrating IBIS simulations and systems planning models through multiple model communications

The next generation of manufacturing simulation

Direct connect emulation and the project life cycle

Using discrete-event computer simulation to test control systems

Opportunities and challenges in manufacturing simulation for busy plant engineers

Implementation of rule-based technology in a shop scheduling system

Just-in-time simulation using artificial intelligence

Intelligent back end of a goal directed simulation environment for discrete-part manufacturing

Simulation and layout of a laser radar production facility

Simulation analysis of a flexible integrated chemical production facility

Simulation assisted design and installation of a flexible assembly system

The use of bottleneck starvation avoidance with queue predictions in shop floor control

Dispatching in an integrated circuit wafer fabrication line

Implementing the results of a manufacturing simulation in a semiconductor line

Expert simulation for on-line scheduling

The user's role in a simulation based scheduling system

Architecture for an integrated simulation /CIM systems

The use of specialized modeling and display techniques in the simulation analysis of a newspaper mailroom distribution system

A simulation model for Washington State juvenille detention facilities

Load sharing in hierarchical distributed systems

A simulation model of the NFS service on an Ethernet local area network

BLusseau,F.-a simulation annealing and resource location in computer networks

Simulated annealing and resource location in computer networks

The constraint method of attrition

Hail storm: a model for determining the survivability of fixed-wing aircraft against small arms

A comparison of serial and parallel processing simulation models of pilot workload

The results of simulating a digital imaging network system in Echelon 3 of deployable combat medical facilities

TCDL - an expert system language for wargaming

A modeling perspective for meteor burst communication

Efficient simulation of cache memories

Techniques for the trace-driven simulation of cache performance

Simulation and analysis of a pipeline processor

NEST: a network simulation & prototyping testbed

CLASS simulation of real time, highly compressed video transmission through an interference limited environment

The use of modelling in long-range computer communications network planning

Simulated real-time intersection signal control

An integrated simulation approach for design and analysis of timber harvesting sytems

Reasoning in time and space: issues in interfacing a graphic computer simulation with an expert system for an intelligent simulation training system

Simulation modeling for emergency medical service systems

Discrete simulation application-scheduling staff for the emergency room

Computer simulation as a method for selecting nurse staffing levels in hospitals

Simulation with PCmodel

Discrete simulation application-scheduling staff for the emergency room

Content Provider	ACM Digital Library
Author	Kapur, R. Kumar, A. P.
Abstract	The Emergency Room Services (ER) of a hospital is a complex probabilistic system where discrete event simulation can be applied. This paper presents the simulation analysis of the ER at Georgetown University Hospital (GUH), using a unique approach to schedule nursing staff.The analysis was accomplished in three phases as follows:a) Patient Classification system: A patient classification system, consisting of five patient acuity levels, was designed to identify degrees of resource needs by objectively delineating the nursing tasks at each acuity level.b) Data Collection and Data Base: A PC based database was specifically designed to collect ER workload information such as patient arrival time and acuity of patient by hour of the day.c) Modeling and Simulation: The model was designed to be sensitive to hourly patient acuity mix levels, since the workload in the ER is primarily dictated by this.The simulation was conducted using SIMAN, a PC based language for a period of 1,000 hours. The first 120 hours of the simulation run were ignored to allow the system to reach steady state. Upon arrival the patients were assigned an acuity, triaged and based on acuity sent either directly to the treatment area or to registration and then treatment area.In the treatment area a patient was seen every hour by the nurse staff till the length of stay was completed. The number of nurses and amount of direct nursing care provided to a patient depended upon the acuity level.Auxiliary patient care such as nurses accompanying a patient to the CT SCAN unit was also incorporated into the model after the treatment block. The auxiliary care parameters were based on probabilities derived from the database.The current schedule was first simulated to validate the model by comparing simulation output with real time data. Ten different types of schedules such as all 8 hour shifts or all 12 hour shifts with lesser number of staff were simulated to examine the impact these schedules had on the ER patient workload.The primary outputs of the SIMAN simulation reports were; patient wait time prior to being seen in the treatment area, patient queue lengths in the waiting area and staff utilization by time of day. .Based on the simulation experiments a feasible cost effective schedule consisting of 12 hours shift is being implemented. The Information System designed in Phase II is now being integrated with the Hospital Information Systems ER Log to provide periodic decision support reports to the ER managers.
Starting Page	1112
Ending Page	1120
Page Count	9
File Format	PDF
ISBN	0911801588
DOI	10.1145/76738.76880
Language	English
Publisher	Association for Computing Machinery (ACM)
Publisher Date	1989-10-01
Publisher Place	New York
Access Restriction	Subscribed
Content Type	Text
Resource Type	Article

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