When to Use Provider Triage in Emergency Departments
研究了急诊科分诊决策，基于稳态多服务台流体近似提出何时采用分诊医生分诊的通用方法，并在教学医院急诊科应用，得到分诊医生优于传统护士分诊的到达率范围，证明方法渐近最优且仿真显示性能接近最优解。
We study triage decisions in emergency departments (EDs) and provide a general procedure for determining when to apply provider triage (PT) based on operational and financial considerations using a steady-state, many-server fluid approximation. We then apply the proposed method in the setting of a teaching hospital’s ED and obtain closed-form expressions for the range of arrival rates for which PT outperforms the traditional nurse triage economically. We show that the proposed solution methodology based on this approximation procedure is asymptotically optimal under a many-server asymptotic regime. We also demonstrate via simulation experiments that the proposed policy performs within 0.82% of the best solution obtained via a computationally intensive total enumeration method. The online appendix is available at https://doi.org/10.1287/mnsc.2017.2982 . This paper was accepted by Noah Gans, stochastic models and simulation.