Research Article
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Implementation of Simulation for the Improvement of Emergency Service Quality by High-Educated Specialist Nurses Employment: Turkish Health System

Year 2018, Volume: 30 Issue: 4, 318 - 338, 31.12.2018
https://doi.org/10.7240/marufbd.395255

Abstract










Emergency departments
are the cornerstone of health care systems. In this study, the work of the
emergency services system in Turkey were examined. The intensities of the
emergency services are becoming immeasurable in the present situation. This is
mainly due to the fact that the majority of patients who come to emergency
services are not urgent in emergency departments. This study suggests that
patients who are not urgent or outpatient in emergency services should be
treated by highly-educated specialist nurses (YSN). In this case, it is
aimed to treat more patients, to reduce the waiting time of the patients and
therefore the duration of the patients' stay in the emergency services. It is
also aimed to increase the efficiency of the resources employed in emergency
services. According to the simulation example applied on 1/24 and 7/24 basis,
it was observed that the number of patients treated by providing employment of
YUH was increased by 26,71% on the basis of 1/24 and 15,13% on the basis of
7/24. The waiting time for treatment was reduced by 38.67% on 1/24 basis and
53.66% on 7/24 basis, respectively, from the time the patients were enrolled in
emergency services. Likewise, the time required for a patient to be treated in
emergency services for treatment was reduced from an average of 82.46 minutes
to 53.97 minutes. Among the findings, it has been seen that the efficiency of
the employment of YUH has provided a balance in the efficiency rates of the
resources by not getting the efficiency as high as the resources employed in
the emergency services. In addition, it has been found that the employment
intensity of physicians decreases with the employment of YUH.
    

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Yüksek-Eğitimli Uzman Hemşire İstihdamı ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi

Year 2018, Volume: 30 Issue: 4, 318 - 338, 31.12.2018
https://doi.org/10.7240/marufbd.395255

Abstract










Acil servisler sağlık sistemlerin
temel taşını oluşturmaktadırlar. Bu çalışmada, Türkiye’deki acil servislerin
çalışma sistemleri incelenmiştir. Mevcut durumdaki acil servislere ait
yoğunluklar ölçülemez hale gelmektedir. Bunun başlıca nedeni acil durumda
olmayan hastaların acil servisleri meşgul etmesidir.  Bu çalışma ile acil servislerde acil olmayan
ya da ayakta tedavi edilebilecek olan hastaların yüksek-eğitimli uzman hemşireler
(YUH) tarafından tedavi edilmesi önerilmiştir. Bu durumda daha fazla hasta
tedavi edilmesi, hastaların bekleme sürelerinin ve dolayısıyla hastaların acil
servislerde kalma sürelerinin azaltılması amaçlanmıştır. Ayrıca acil
servislerde istihdam edilen kaynakların verimliliğinin arttırılması
hedeflenmiştir. 1/24 ve 7/24 esasına göre uygulanan simülasyon örneği ile YUH
istihdamı sağlanarak tedavi edilen hasta sayısında 1/24 esasına göre %26,71 ve
7/24 esasına göre %15,13 oranında artış sağlandığı görülmüştür. Hastaların acil
servise kayıt yaptıkları andan itibaren tedavi olmak için bekledikleri süre
1/24 esasına göre %38,67 ve 7/24 esasına göre %53,66 oranlarında iyileşme
sağlanarak bekleme zamanı düşürülmüştür. Aynı şekilde bir hastanın tedavi olmak
için acil servislerde geçirmesi gereken süre ortalama 82,46 dakikadan 53,97
dakikaya düşürülmüştür. Bulgular arasında, acil servislerde istihdam edilen
kaynaklardan yeteri kadar verim alınamamasıyla YUH istihdamı sayesinde
kaynaklara ait verimlilik oranlarında bir denge sağlandığı görülmüştür. Ek
olarak, YUH istihdamı ile doktorların çalışma yoğunluklarının azaldığı tespit
edilmiştir.

References

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  • 23. Denton, B. T. (2013). Handbook of healthcare operations management: Springer.
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  • 25. Duguay, C., & Chetouane, F. (2007). Modeling and improving emergency department systems using discrete event simulation. Simulation, 83(4), 311-320.
  • 26. Durand, A.-C., Palazzolo, S., Tanti-Hardouin, N., Gerbeaux, P., Sambuc, R., & Gentile, S. (2012). Nonurgent patients in emergency departments: rational or irresponsible consumers? Perceptions of professionals and patients. BMC Research Notes, 5, 525-525. doi:10.1186/1756-0500-5-525.
  • 27. Ely, E. W., Stephens, R. K., Jackson, J. C., Thomason, J. W. W., Truman, B., Gordon, S., . . . Bernard, G. R. (2004). Current opinions regarding the importance, diagnosis, and management of delirium in the intensive care unit: A survey of 912 healthcare professionals*. Critical Care Medicine, 32(1).
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  • 32. Günal, M. M., & Pidd, M. (2010). Discrete event simulation for performance modelling in health care: a review of the literature. Journal of Simulation, 4(1), 42-51.
  • 33. Gupta, D., & Denton, B. (2008). Appointment scheduling in health care: Challenges and opportunities. IIE Transactions, 40(9), 800-819. doi:10.1080/07408170802165880.
  • 34. Hart, A. (2001). Making sense of statistics in healthcare: Radcliffe Publishing.
  • 35. Hung, G. R., Whitehouse, S. R., O'neill, C., Gray, A. P., & Kissoon, N. (2007). Computer modeling of patient flow in a pediatric emergency department using discrete event simulation. Pediatric emergency care, 23(1), 5-10.
  • 36. Jun, J., Jacobson, S. H., & Swisher, J. R. (1999). Application of discrete-event simulation in health care clinics: A survey. Journal of the operational research society, 109-123.
  • 37. Keck, M. (2003). Hospital emergency department resource utilization and optimization system. In: Google Patents.
  • 38. Kim, S. E., Kim, C. W., Lee, S. J., Oh, J. H., Lee, D. H., Lim, T. H., . . . Jung, J. H. (2015). A questionnaire survey exploring healthcare professionals' attitudes towards teamwork and safety in acute care areas in South Korea. BMJ Open, 5(7).
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There are 63 citations in total.

Details

Primary Language Turkish
Subjects Engineering
Journal Section Research Articles
Authors

Abdulkadir Atalan 0000-0003-0924-3685

Cem Çağrı Dönmez

Yasemin Ayaz Atalan

Publication Date December 31, 2018
Acceptance Date December 11, 2018
Published in Issue Year 2018 Volume: 30 Issue: 4

Cite

APA Atalan, A., Dönmez, C. Ç., & Ayaz Atalan, Y. (2018). Yüksek-Eğitimli Uzman Hemşire İstihdamı ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi. Marmara Fen Bilimleri Dergisi, 30(4), 318-338. https://doi.org/10.7240/marufbd.395255
AMA Atalan A, Dönmez CÇ, Ayaz Atalan Y. Yüksek-Eğitimli Uzman Hemşire İstihdamı ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi. MAJPAS. December 2018;30(4):318-338. doi:10.7240/marufbd.395255
Chicago Atalan, Abdulkadir, Cem Çağrı Dönmez, and Yasemin Ayaz Atalan. “Yüksek-Eğitimli Uzman Hemşire İstihdamı Ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi”. Marmara Fen Bilimleri Dergisi 30, no. 4 (December 2018): 318-38. https://doi.org/10.7240/marufbd.395255.
EndNote Atalan A, Dönmez CÇ, Ayaz Atalan Y (December 1, 2018) Yüksek-Eğitimli Uzman Hemşire İstihdamı ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi. Marmara Fen Bilimleri Dergisi 30 4 318–338.
IEEE A. Atalan, C. Ç. Dönmez, and Y. Ayaz Atalan, “Yüksek-Eğitimli Uzman Hemşire İstihdamı ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi”, MAJPAS, vol. 30, no. 4, pp. 318–338, 2018, doi: 10.7240/marufbd.395255.
ISNAD Atalan, Abdulkadir et al. “Yüksek-Eğitimli Uzman Hemşire İstihdamı Ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi”. Marmara Fen Bilimleri Dergisi 30/4 (December 2018), 318-338. https://doi.org/10.7240/marufbd.395255.
JAMA Atalan A, Dönmez CÇ, Ayaz Atalan Y. Yüksek-Eğitimli Uzman Hemşire İstihdamı ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi. MAJPAS. 2018;30:318–338.
MLA Atalan, Abdulkadir et al. “Yüksek-Eğitimli Uzman Hemşire İstihdamı Ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi”. Marmara Fen Bilimleri Dergisi, vol. 30, no. 4, 2018, pp. 318-3, doi:10.7240/marufbd.395255.
Vancouver Atalan A, Dönmez CÇ, Ayaz Atalan Y. Yüksek-Eğitimli Uzman Hemşire İstihdamı ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi. MAJPAS. 2018;30(4):318-3.

Marmara Journal of Pure and Applied Sciences

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