ED1B Arrivals with Acuity Advanced

To analyze your raw data and prepare it to represent the arrivals of an Emergency Department with patient acuity levels. This can be used with the Triage model object or to feed into a model created from scratch.

Where to Find the Model Object

The following model object can be found in the model objects directory:

• ED \ ED1B Arrivals with Acuity Advanced.

This model object is a part of a 8 model object Emergency Department series that can be accessed under the category ED.

1. ED1B Arrivals with Acuity Advanced
2. ED2 Triage
3. ED3_a Treatment with Fast Track
4. ED3_b Treatment with Fast Track Using Common Lab
5. ED4_a Patient Discharge
6. ED5_a Room Cleaning
7. ED6_a Patient Admit
8. ED7_a Resource Optimizer

Difficulty Level

• Ease of Use: Easy
• Ease of Modification: Easy

How to Use the Model Object

1. Open Your Model: Open your model or create a new blank model.
2. Insert the Model Object into Your Model
   1. Locate the model object ED1 Arrivals with Acuity and select the insert button.
   2. Move the cursor to the point of insertion and left mouse-click. The upper left corner of the model object will be inserted at the location of the mouse-click.
3. Connect to Your Model: Create a percentage route from the black box to the rest of your model. If you are combining the ED models, connect the black box to ED Critical? from ED2 Triage model object.This Model Object is best when used with other ED model objects Scenario Parameters
4. Open the Excel File: Right click on the Healthcare Arrivals Sheet Excel icon and click on the third option from the bottom to open the Healthcare Arrivals vx-x Excel file, where x-x represents the version number of the Excel file.Before using this Excel file for the first time, or after changing your model name, make sure that a manual export of data is done via ProcessModel. From your model, click Tools \ Export Data, click ‘Yes’ to all prompts until the data export file opens, close the data file and then use this Excel file.Click Enable Content if prompted
5. Enter Raw Data: Once the Weekly Pattern Arrivals vx-x Excel file opens you should land on the Input worksheet.
   1. Copy your date and time data and paste into cell A3. You need at least 6 months of data. Use the Excel date and time format, sample data is included.Sample data must be removed prior to entry of your data.You must provide at-least 24 weeks worth of data
   2. Copy your acuity data and paste into cell B3.If some data points (date and time) have acuity levels missing, you can leave the corresponding cells as blank.
   3. Enter the highest level of acuity in your model to cell C3. Example; If you have acuity levels from 1 to 5 and the highest acuity is 1,  enter 1. If the highest acuity level is 5 then enter 5.Enter the number that is considered the highest acuity level in your system. You must provide a value between 1 to 9, based on what the highest acuity is in your data.In ProcessModel, priorities with the highest number receive the highest priority. The Excel spreadsheet will transform your acuity numbers so that they will work with the simulation.
   4. In cell D3 and D4, enter the time at which you need to change the acuity, the time has to be in 24 hours format with lowest time in the first cell and the highest time in the second cell.
6. Prepare Arrival Data for ProcessModel: Click the button titled Prepare Arrival Data for ProcessModel and allow 1 minute for the analysis (depends on the speed of your processor and the size of the file). Once completed you will land on the Same Pattern for All Days worksheet.Follow instructions to install Histogram add-on before using the sheet
7. Choose Same or Unique Pattern for Days: After preparing your data for ProcessModel, choose one of the following two paths and then goto the relevant worksheet.
   1. Same Pattern for All Days: When there is nominal difference in the daily pattern between day to day arrivals in the data. Daily volumes will be different.
   2. Unique Pattern by Day of Week: When there is major difference of patterns between days of the week (i.e. Sundays have a daily pattern different from Mondays).
8. Copy Data to ProcessModel: The rest of the instructions will be the same for Same Pattern for All Days or Unique Pattern by Day of Week.
   1. Copy the data in column B from B5 onwards by pressing the Copy Arrivals button.
   2. Goto ProcessModel and open Stat::Fit via Tools \ Stat::Fit.
   3. Paste the data into Stat::Fit.
   4. Fit the data into a distribution by clicking Auto-fit in the toolbar and then OK.
   5. Review the acceptable distributions and then click Export from the toolbar.
   6. Select the acceptable distribution from the Fitted Distribution and then click OK.
   7. Return to ProcessModel, click on the arrival route and then paste (CTRL + V) the distribution in the Quantity per arrival field in the Properties Dialog. Make sure you remove the old distribution before pasting the new one in
   8. Return to the Excel file and click Copy Action Logic.
   9. Return to ProcessModel, click on the black box and then open the Action Logic window via the Properties Dialog. Remove the old action logic and paste (CTRL + V) in the new action logic.
9. Completion: The model object is now integrated into your model, you should now be able to save and then simulate the model.You should now be ready to add ED2 Triage.

Controls Usage

Attributes:

1. a_Acuity: The acuity level assigned to patients from historical patterns. This can range from 1 to 9. You indicate what number represents the highest acuity in your system.

Advance Topics

How do I choose between or Same Pattern for All Days or Unique Pattern by Day of Week?

You can choose between Same Pattern for All Days or Unique Pattern by Day of Week by looking at the data and charts after you have prepared the data (step 6) for ProcessModel.

If there is nominal difference in the daily pattern between day to day arrivals, then use can use Same Pattern for All Days.

The difference between values is 1% or less

If there is a major difference in the daily pattern between day to day arrivals, then use can use Unique Pattern by Day of Week.

The difference between values is over 7% on some days