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.
Patient flows ED and Beyond
Extension of IM-14124 with an adjusted bed capacity stock. For backlog and services see IM-8382
Hospital Emergency and Elective Admission Interaction Simulation 3
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
Cost Quality Workload Dynamics
This is a simpler version of Insight 649 showing the flow of Older People among the Community Hospital and Aged Care Residences
Aged Care and Hospital Flows Simple
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.
ED Flows with Acute and FastTrack Areas
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
ED Presentation Choices Context
WIP for a HEalth Care Learning Thread for SOHT a proof of concept before adding to SysNet
Patient Flow Learning Threads
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
Initial Conceptual Model for NEAT 4 hour rule Project
From Peter Lacey's Whole Systems Partnership UK NHS ithink model
End of Life Cohort Model
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
Hospital Flow for Flexicare Project
An example of why it's so critical to understand where the boundaries are when considering a system. (developed from Eric Wolstenholme's Archetype examples by Gene Bellinger)
YouTube Video
Hospital Early Discharge Boundaries
WIP for regional integration based on NHPA and IHPA activities in Australia
National Health Performance and Pricing
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
WIP ED Boarding - Days
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.
ED-Imaging Patient Flow 2
Clone of IM-10536 WIP for LHN Individual Hospital O Month of October 2013, with joined up flows
Individual Hospital Monthly Performance 2
Dynamics of Emergency Room Crowding a simple uncalibrated simulation which includes Wards and some simple internal ED feedback effects
Emergency Room and Wards Patient Flow Simulation
Simplest ED Model for Weekend ED Performance with 1 ED area IM-11079 Ward net discharges are extended with Ward and Waitlist inflow and outflow details (informed by IM-7981) WIP
Clone of ED Flows extended to Ward and Waitlist Flows
A work in progress conceptual model based on Using system dynamics principles for conceptual modelling of publicly funded hospitals by HJ Wong et al Journal of the Operational Research Society advance online publication, 27 April 2011 doi:10.1057/jors.2010.164. Linked concepts with annotated definitions.
ED Crowding Hospitals and Beyond Linked Concepts
See reference in diagram notes. WIP for Environment part of primary care regional model
Clone of The Ecology of Medical Care
Concept map of patient flow through ED
ED Patient Flow Concept Map
Unfolding WIP of Eric Wolstenholme's explanation of hospital congestion from March 2022 Youtube video and online stella presentation. Use of cascading interlinked archetypes. See Kumu version, early discharge boundaries IM for an earlier version and Generic Archetypes IM from Gene and Simpler Version IM
Hospital congestion cascading archetypes
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
ED flows by triage totals with hourly arrival
Flows between acute hospital and aged care for older people. See IM-1012 for a simpler version
Aged Care and Hospital Flows
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
ED Clinical Care Processes
