Lean healthcare integrated with discrete event simulation and design of experiments: an emergency department expansion
Bibliographic record
Abstract
Background. Discrete Event Simulation (DES) and Lean Healthcare are management tools that are efficient and assist in the quality and efficiency of health services. In this sense, the purpose of the study is to use lean principles jointly with DES to plan the expansion of a Canadian emergency department and to the demand that comes from small closed care centers. Methods. For this, we used simulation and modeling method. We simulated the emergency department in FlexSim Healthcare® software and, with the Design of Experiments (DoE), we defined the optimal number of locations and resources for each shift. Results. The results show that the ED cannot meet expected demand in the current state. Only 17.2% of the patients were completed treated, and the Length of Stay (LOS), on average, was 2213.7, with a confidence interval of (2131.8 - 2295.6) minutes. However, after changing decision variables, the number of treated patients increased to 95.7% (approximately 600%). Average LOS decreased to 461.2, with a confidence interval of (453.7 - 468.7) minutes, about 79.0%. In addition, the study shows that emergency department staff are balanced, according to Lean principles.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".