Abstract for:Emergency Department Crowding in Singapore: Ways to Restore the Balance between Demand for and Supply of Emergency Medicine

Emergency Departments (EDs) worldwide are confronted with rising patient volumes causing significant strains on both Emergency Medicine and entire healthcare systems. As a consequence, many EDs globally are in a situation where the demand for ED care by far outstrips its supply?a phenomenon called Emergency Department (ED) crowding. Besides compromising overall ED performance, ED crowding can impair the quality of care delivered to patients and lead to longer patient waiting times. In Singapore, total ED attendance at public hospitals has grown significantly, that is, roughly 5.57 % per year between 2005 and 2016 and, as a consequence, emergency physicians (EPs) have to cope with patient volumes way above the optimal workload. The purpose of this study is to create a virtual world of a hospital-based ED in Singapore using system dynamics in order to visualize and improve patient flows within the ED. Based on the simulation model, we analyze how ED manpower needs to be adjusted in order to dissolve congestions and smooth ED patient flows. Besides optimal staffing, we test the impact of two additional policies on ED crowding: co-location of general practitioners in the ED and an increase in capacity of the associated hospital.