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http://ssrn.com/abstract=1911847
 
 

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Complexity-Augmented Triage: A Tool for Improving Patient Safety and Operational Efficiency


Soroush Saghafian


Harvard University - Harvard Kennedy School (HKS)

Wallace J. Hopp


University of Michigan, Stephen M. Ross School of Business

Mark P. Van Oyen


University of Michigan at Ann Arbor

Jeffrey S. Desmond


University of Michigan Hospitals

Steven L. Kronick


University of Michigan Hospitals

December 4, 2013

Manufacturing and Service Operations Management (M&SOM), Forthcoming

Abstract:     
Hospital Emergency Departments (ED's) typically use triage systems that classify and prioritize patients almost exclusively in terms of their need for timely care. Using a combination of analytic and simulation models, we demonstrate that adding an up-front estimate of patient complexity to conventional urgency-based classification can substantially improve both patient safety (by reducing the risk of adverse events) and operational efficiency (by shortening the average length of stay). Moreover, we find that ED's with high resource (physician and/or examination room) utilization, high heterogeneity in the treatment time between simple and complex patients, and a relatively equal number of simple and complex patients benefit most from complexity-augmented triage. Finally, we find that: (1) Although misclassification of a complex patient as simple is slightly more harmful than vice versa, complexity-augmented triage is relatively robust to misclassification error rates as high as 25%. (2) Streaming patients based on complexity information and prioritizing them based on urgency is better than doing the reverse. (3) Separating simple and complex patients via streaming facilitates the application of lean methods that can further amplify the benefit of complexity-augmented triage.

Number of Pages in PDF File: 42

Keywords: Healthcare Operations Management, Emergency Department, Triage, Priority Queues, Patient Prioritization

JEL Classification: C44, L89, I18


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Date posted: August 19, 2011 ; Last revised: April 4, 2014

Suggested Citation

Saghafian, Soroush and Hopp, Wallace J. and Van Oyen, Mark P. and Desmond, Jeffrey S. and Kronick, Steven L., Complexity-Augmented Triage: A Tool for Improving Patient Safety and Operational Efficiency (December 4, 2013). Manufacturing and Service Operations Management (M&SOM), Forthcoming. Available at SSRN: http://ssrn.com/abstract=1911847 or http://dx.doi.org/10.2139/ssrn.1911847

Contact Information

Soroush Saghafian (Contact Author)
Harvard University - Harvard Kennedy School (HKS) ( email )
79 John F. Kennedy Street
Cambridge, MA 02138
United States
Wallace J. Hopp
University of Michigan, Stephen M. Ross School of Business ( email )
701 Tappan Street
Ann Arbor, MI MI 48109
United States
Mark P. Van Oyen
University of Michigan at Ann Arbor ( email )
500 S. State Street
Ann Arbor, MI 48109
United States
Jeffrey S. Desmond
University of Michigan Hospitals ( email )
1500 E. Medical Center Drive
Ann Arbor, MI 48109
United States
Steven L. Kronick
University of Michigan Hospitals ( email )
1500 E. Medical Center Drive
Ann Arbor, MI 48109
United States
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