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瀏覽:Essaymint:专注软文代写和代写作业等服务,作业代写-100%原创高分 日期:2020-01-12

Essaymint:专注软文代写和代写作业等服务,作业代写-100%原创高分   介紹莫斯特卡斯特綜合醫院有一個繁忙的事故和急診(A&E)部門(請注意:在某些國家/地區,這簡稱為急診科)。 目前,由于患者經常需要在A&E中等待很長時間,因此其性能尚不令人滿意。 目前,員工人數的時間表因各種因素(例如,員工人數,假期等)而每天變化。醫院計劃招聘一些額外的員工,但它不知道需要多少員工。醫院想知道在一天中的不同時間應該有多少員工才能取得良好的績效。

  急診科醫院為您提供了有關急診科當前工作方式的以下信息:急癥室有兩種類型的患者:緊急患者和非緊急患者。 患者在急癥室接受各種治療和評估,然后離開。 離開急癥室稱為“出院”。 病人可能會把急癥室(A&E)送到各個目的地,例如,他們可能會回家,去另一個護理提供者(例如護理院)或去醫院的病房。患者隨機進入急診室。 在幾周內的三個時間間隔內對到達的患者總數進行了計數。 時間間隔的平均值如下:

Time interval

Non-urgent

Urgent

Midnight – 8 a.m.

48

1

8 a.m. – 4 p.m.

128

4

4 p.m. – midnight

80

2

例如,這意味著在午夜至上午8點之間平均有48名非緊急患者和1名緊急患者到達。緊急患者受重傷,通常是通過救護車到達的。 當他們到達時,他們會得到緊急護理(例如復蘇)。 他們到達后必須立即進行。 如有必要,執行其他任務的醫生將停止他們正在做的事情以提供緊急護理。 醫院僅設有可同時為三名患者提供緊急護理的設施。 如果有三名患者接受緊急護理治療,并且發生另一例緊急情況,那么該患者將被送往另一家醫院。 緊急護理時間的數據平均為60分鐘,標準差為20分鐘。 對數正態分布對于該數據被認為是現實的。如果醫生停止執行提供緊急護理的任務,那么任何醫生都可以完成該任務-即另一位醫生可以完成原始任務。在接受緊急護理后,有60%的緊急患者離開急診室并出院(通常去醫院的病房)。 40%的緊急患者在A&E中接受進一步治療。這種治療不需要立即進行,但它確實比非緊急患者優先。治療后,這些患者隨后被出院(通常再次送往醫院病房)。緊急患者在A&E中最多接受一種治療活動。這些處理時間的數據平均為30分鐘,標準偏差為15分鐘。對數正態分布也被認為對該數據是現實的。非緊急患者有各種情況或受傷,需要通過“分類”程序來處理。首先,患者會見接待人員(1人)并進行登記(記錄其姓名和個人詳細信息)。此活動所用時間的唯一可用信息是估計的最小值為1.5分鐘,模式為2.5分鐘,最大值為5分鐘。然后,他們會見分診護士,對患者進行初步評估。此活動所用時間的唯一可用信息是估計的最小值為3分鐘,模式為5分鐘,最大值為10分鐘。見到分診護士后,一些病人已出院。如果他們沒有出院,患者接下來會去看醫生進行更詳細的評估。在看醫生之后,有些患者必須在A&E中從醫生那里得到特定的治療(例如醫療程序或掃描)。活動的順序是患者總是交替看醫生并得到治療。患者在A&E中最多接受兩種治療和三種醫生評估。這些活動中的任何一項都可能被釋放。百分比如下:

Stage

% to next process

% discharged

Triage

80%

20%

1st doctor assessment

70%

30%

1st treatment

80%

20%

2nd doctor assessment

25%

75%

2nd treatment

50%

50%

3rd doctor assessment

0%

100%

  The times for the doctor assessments are believed to follow a lognormal distribution. The times for the 1st assessment have mean of 15 minutes and a standard deviation of 4 minutes. The times for the 2nd assessment have a mean of 12 minutes and a standard deviation of 6 minutes. The times for the 3rd assessment also have a mean of 12 minutes and a standard deviation of 6 minutes.

  The times for the treatments have not been analysed. However, a spreadsheet containing a sample of 100 treatment times is provided on Moodle with this document. It is believed that there is no difference in the distribution of times for 1st and 2nd treatments.

Essaymint:专注软文代写和代写作业等服务,作业代写-100%原创高分   Staff work shifts of: midnight – 8 a.m., 8 a.m. – 4 p.m., 4 p.m. – midnight. The hospital can schedule any number of nurses and doctors to each shift. A nurse costs 0.6 of the cost of a doctor. The standard pay rate applies to the shift of 8 a.m. – 4 p.m. Doctors and nurses working on the shift from midnight – 8 a.m. receive extra pay and cost an additional 30%, those working on the shift from 4 p.m. – midnight cost an additional 20%.

Essaymint:专注软文代写和代写作业等服务,作业代写-100%原创高分   The triage assessments are done by nurses. The doctor assessments and the treatments for urgent and non-urgent patients are all provided by doctors. Although there are different types and levels of doctor, at this stage the hospital would just like to know the total number of doctors required (i.e., assume that the doctors can carry out any assessments and treatments). Also assume that each assessment and treatment is provided by one doctor (i.e., doctors work alone).

  The availability of space and facilities mean that there are maximum numbers for each process that can simultaneously take place at any one time. The maximum number of triage assessments is 5, the maximum number of doctor assessments is 6, the maximum number of non-urgent treatments is 6, the maximum number of urgent care is 3, the maximum number of urgent treatments is 3.

  Patients wait between processes in the waiting area. There is plenty of space in this area.

Essaymint:专注软文代写和代写作业等服务,作业代写-100%原创高分   The current government performance target is that 95% of patients should be discharged from A&E within 4 hours of arriving at A&E. The hospital aims to meet this target. It is possible in the future that 90% might be considered acceptable and the hospital would like to know what difference it would make if they use this target instead. The hospital would like to minimise staff costs whilst providing a good service. They are also interested in any other useful measures of performance although they are not sure what these might be.

Essaymint:专注软文代写和代写作业等服务,作业代写-100%原创高分   Your task

  The hospital know that you have expertise in simulation modelling and they would like you to build a simulation model of the A&E department and to use the model to provide advice on how they should run the department. Your report should include specific recommendations on what the hospital should do.

  No other information is available at the moment and so you will need to base your analysis on the above description of the system. State any assumptions that you make about the system. You should build your own simulation model starting with the blank Witness Startup model.

  The hospital may be able to obtain more information and data that could be used for further work on the model over the summer, although they are not sure what would be useful. Please include in your report an explanation of what further data would be helpful and how you would use it. The hospital are also interested in knowing about any limitations of the model and your analysis.

Essaymint:专注软文代写和代写作业等服务,作业代写-100%原创高分   Simulation software

  You must use the Witness simulation software for your model.

  Submission

  Each group is required to submit the following two items through Moodle. Only one person in the group needs to submit the files (do not submit the files several times under the different people in the group).

  • A written group report as a Microsoft Word document describing the project. The maximum length of the report (excluding appendices) is 5000 words. You can assume that the reader of the report is familiar with simulation. Hence, you do not need to explain general simulation concepts or simulation terminology. You need to explain clearly how your model works and what you did for each of the simulation tasks. Credit can only be given based on what you put in the report and so allow enough time for writing the report. Some analysis can be included in an appendix but do not include many pages of model code or statistical output in the appendices without any explanation in the report.

  • A Witness simulation model file containing a working version of your model.

  This is the submission deadline and any submission after this deadline is subject to standard departmental penalties, unless you have been given an extension for exceptional reasons. The extension must be granted by me before the deadline.


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