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Kenneth W. McKinley,Kelly N. Z. Rickard,Finza Latif,Theresa Wavra,Julie Berg,Sephora Morrison,James M. Chamberlain,Shilpa J. Patel 대한의료정보학회 2022 Healthcare Informatics Research Vol.28 No.1
Objectives: The aim of this study was to use discrete event simulation (DES) to model the impact of two universal suiciderisk screening scenarios (emergency department [ED] and hospital-wide) on mean length of stay (LOS), wait times, andoverflow of our secure patient care unit for patients being evaluated for a behavioral health complaint (BHC) in the ED of alarge, academic children’s hospital. Methods: We developed a conceptual model of BHC patient flow through the ED, incorporatinganticipated system changes with both universal suicide risk screening scenarios. Retrospective site-specific patienttracking data from 2017 were used to generate model parameters and validate model output metrics with a random 50/50split for derivation and validation data. Results: The model predicted small increases (less than 1 hour) in LOS and waittimes for our BHC patients in both universal screening scenarios. However, the days per year in which the ED experiencedsecure unit overflow increased (existing system: 52.9 days; 95% CI, 51.5–54.3 days; ED: 94.4 days; 95% CI, 92.6–96.2 days;and hospital-wide: 276.9 days; 95% CI, 274.8–279.0 days). Conclusions: The DES model predicted that implementation of eitheruniversal suicide risk screening scenario would not severely impact LOS or wait times for BHC patients in our ED. However,universal screening would greatly stress our existing ED capacity to care for BHC patients in secure, dedicated patientareas by creating more overflow.