ED2 Triage

To prioritize according to acuity assigned in the arrival, to forward the most severe patients first,  to allow for the separate queuing and prioritization of a “Fast Track” and to allow people that have waited to long to exit the system as LWBS.

Where to Find the Model Object

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

• ED \ ED2 Triage

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: Difficult

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 ED2 Triage 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.In case you are combining ED models, move the cursor to the left of the black dot inserted with the last model object, then click.
3. Connect to Your Model: Create a percentage route between the start of your model and ED Critical?. In case you are combining ED models, , use a percentage route to connect the black box to ED Critical?.Connect the black box after Triage Patient to the rest of your model. Incase you are connecting ED models, connect the black box to the starting black box in ED3_a Treatment with Fast Track or ED3_b Treatment with Fast Track Using Common Lab. This Model Object is best when used with other ED model objects Scenario Parameters
4. Move Objects: Move all blue objects to a notes layer on your model.
5. Define Values: Change the scenario parameter values based on the Scenario Parameters information provided at the end.
6. Review
   1. Objects: The Fast Track Trigger Activity controls hours of operation for the Fast Track. This is only operational if the fast track scenario is on. There are two arrival routes on this trigger on arrival routes turns the fast track on, while the other turns it off.
   2. Action Logic: The following objects contain action logic, review the action logic if needed.
      1. Triage Patient activity.
      2. Route between Triage Patient and Waiting Room.
      3. Waiting Room storage.
      4. Route from Waiting Room to the black box.
      5. Route from Waiting Room to Terminate 1 activity.
      6. Both arrival routes coming from Fast track Trigger entity to Fast Track Trigger Activity.
      7. Waiting Room Controller activity.
7. 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 ED3_a Treatment with Fast Track or ED3_b Treatment with Fast Track Using Common Lab model object.

Controls Usage

Attributes:

1. a_Dir1: The direction the entity will take from the waiting room.
2. a_StartWait1: To know the time when the entity entered waiting room.
3. a_MaxWait1: To capture the max wait time from the scenario.
4. a_TotalWait1: To know the total wait time of an entity.
5. a_VATime: To reset the value added time when the entity leaves waiting room.
6. a_Acuity: To set the priority of entities.
7. a_Rand: Temporary to this model object. Used in the ED Arrivals model object.
8. a_Hr: Temporary to this model object. Used in the ED Arrivals model object.
9. a_FTV: Temporary to this model object. Used in the ED Arrivals model object.
10. a_STV: Temporary to this model object. Used in the ED Arrivals model object.
11. a_Disposition: Defines what area a patient will be transferred to in the ED (Regular ER room, Fast Track Room or a CC Trauma Room. Used in the Treatment model object).

Variables:

1. v_Gate1: The gate that trigger checks which way an entity should move.
2. v_FT_Available: Used to allow patients into the Fast Track. FT_On or FT_OFF
3. v_Waiting_TimeAllAcuity: the waiting time for all patients that enter the waiting room and later move into one of the treatment rooms. This excludes The most acute patients.
4. v_Waiting_Time_Acuity4: How long patients waited, in the waiting room, that had acuity level 4 (remember, this is the acuity after the numbers have been transformed when data was imported via ED1 Arrivals with Acuity).
5. v_Waiting_Time_Acuity3: How long patients waited that had acuity level 3.
6. v_Waiting_Time_Acuity2: How long patients waited that had acuity level 2.
7. v_Waiting_Time_Acuity1: How long patients waited that had acuity level 1.
8. v_Waiting_Time_FT: How long a patient waited in the waiting room before being placed in a fast track bed.
9. v_Waiting_Time_ER_Bed: How long a patient waited in the waiting room before being placed in an ER bed.
10. v_Waiting_Time_LWOBS: How long a patient waited before finally deciding to leave without being seen.
11. v_Door_To_Bed_ALL: The time from entry to being placed in a bed (all but the most acute patents.
12. v_Door_To_Bed_FT: The time from entry to being placed in a Fast Track bed.
13. v_Door_To_Bed_ER_Bed: The time from entry to being placed in a ER bed.
14. v_Total_In_Waiting_Room: The number of people in the “waiting area”

Scenario Parameters:

1. s_MaxWait1: The amount of time entities will wait in the waiting room before the exit without moving forward in the model.
2. s_LoopDelay1: The amount of time between re-sequence of patients in the waiting room.
3. s_Numb_Acuity_Levels: How many levels of acuity exist in this system (i.e. 3 or 4 or 5, etc.).
4. s_Acuity_HowManyToFastTrack: How many acuity levels are allowed to be transferred to the Fast Track.
5. s_Fast_Track_On_OneIsYes: Signals that a fast track is available (1 indicates yes and 0 indicates no).
6. s_Fast_Track_StartTime: The clock time when the Fast Track opens (military time).
7. s_Fast_Track_EndTime: The clock time when the Fast Track closes (military time).
8. s_Triage_Time: The span of time to triage a patient. May be entered as a distribution.
9. s_ER_Beds: The number of Emergency Room Beds
10. s_FT_Beds: The number of Fast Track Beds s_TR_Beds: The number of Trauma Units