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1.
Stud Health Technol Inform ; 210: 145-9, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25991119

RESUMEN

Patient journey in the Pediatric Emergency Department is a highly complex process. Current approaches for modeling are insufficient because they either focus only on the single ancillary units, or therefore do not consider the entire treatment process of the patients, or they do not account for the dynamics of the patient journey modeling. Therefore, we propose an agent based approach in which patients and emergency department human resources are represented as autonomous agents who are able to react flexible to changes and disturbances through pro-activeness and reactiveness. The main aim of this paper is to present the overall design of the proposed multi-agent system, emphasizing its architecture and the behavior of each agent of the model. Besides, we describe inter-agent communication based on the agent interaction protocol to ensure cooperation between agents when they perform the coordination of tasks for the users. This work is integrated into the ANR HOST project (ANR-11-TecSan-010).


Asunto(s)
Vías Clínicas/organización & administración , Servicio de Urgencia en Hospital/organización & administración , Modelos Organizacionales , Pase de Guardia/organización & administración , Pediatría/organización & administración , Flujo de Trabajo , Sistemas de Apoyo a Decisiones Clínicas/organización & administración , Técnicas de Apoyo para la Decisión , Atención a la Salud/organización & administración , Francia , Grupo de Atención al Paciente/organización & administración
2.
J Biomed Inform ; 54: 315-28, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25554685

RESUMEN

The workflow models of the patient journey in a Pediatric Emergency Department (PED) seems to be an effective approach to develop an accurate and complete representation of the PED processes. This model can drive the collection of comprehensive quantitative and qualitative service delivery and patient treatment data as an evidence base for the PED service planning. Our objective in this study is to identify crowded situation indicators and bottlenecks that contribute to over-crowding. The greatest source of delay in patient flow is the waiting time from the health care request, and especially the bed request to exit from the PED for hospital admission. It represented 70% of the time that these patients occupied in the PED waiting rooms. The use of real data to construct the workflow model of the patient path is effective in identifying sources of delay in patient flow, and aspects of the PED activity that could be improved. The development of this model was based on accurate visits made in the PED of the Regional University Hospital Center (CHRU) of Lille (France). This modeling, which has to represent most faithfully possible the reality of the PED of CHRU of Lille, is necessary. It must be detailed enough to produce an analysis allowing to identify the dysfunctions of the PED and also to propose and to estimate prevention indicators of crowded situations. Our survey is integrated into the French National Research Agency (ANR) project, titled: "Hospital: Optimization, Simulation and avoidance of strain" (HOST).


Asunto(s)
Vías Clínicas , Servicio de Urgencia en Hospital , Modelos Teóricos , Flujo de Trabajo , Niño , Humanos , Informática Médica , Pediatría , Interfaz Usuario-Computador
3.
Stud Health Technol Inform ; 205: 338-42, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25160202

RESUMEN

The greatest source of delay in patient flow is the waiting time from the health care request, and especially the bed request to exit from the Pediatric Emergency Department (PED) for hospital admission. It represents 70% of the time that these patients occupied in the PED waiting rooms. Our objective in this study is to identify tension indicators and bottlenecks that contribute to overcrowding. Patient flow mapping through the PED was carried out in a continuous 2 years period from January 2011 to December 2012. Our method is to use the collected real data, basing on accurate visits made in the PED of the Regional University Hospital Center (CHRU) of Lille (France), in order to construct an accurate and complete representation of the PED processes. The result of this representation is a Workflow model of the patient journey in the PED representing most faithfully possible the reality of the PED of CHRU of Lille. This model allowed us to identify sources of delay in patient flow and aspects of the PED activity that could be improved. It must be enough retailed to produce an analysis allowing to identify the dysfunctions of the PED and also to propose and to estimate prevention indicators of tensions. Our survey is integrated into the French National Research Agency project, titled: "Hospital: optimization, simulation and avoidance of strain" (ANR HOST).


Asunto(s)
Servicio de Urgencia en Hospital/organización & administración , Modelos Organizacionales , Pase de Guardia/organización & administración , Pediatría/organización & administración , Listas de Espera , Flujo de Trabajo , Carga de Trabajo , Simulación por Computador , Aglomeración , Modelos Estadísticos
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