Development of a Simulation Environment to Study Emergency Department Information Technology

Introduction: This article presents a simulation architecture for a patient tracking system simulator to study caregiver performance in emergency departments (EDs). The architecture integrates discrete event simulation modeling with clinical patient information. Evaluation components for electronic patient tracking system displays are also described. Methods: A simulation of an ED electronic whiteboard was developed to study situation awareness metrics. Dynamic process data from an actual ED was used to generate simulation parameters including patient arrivals at various hours, distribution of severities, times required to treat the ED patients, and ancillary turnaround times (laboratory and radiology). A team of industrial engineers and ED physicians contributed demographic and clinical information for simulator patients. ED simulation parameters were combined with clinical information resulting in an event timeline database. Event timelines were used to populate a front-end patient-tracking system display simulation. Results: The resulting patient-tracking system display simulation consists of underlying software, desktop and large-screen displays, a phone call/pager system, and typical tasks that enhance the realism of the simulation experience. The system can evaluate the impact of display parameters and ED operations on user performance. Conclusions: Modular design of the patient-tracking system display simulation helps adaptation for different studies to support various interface features and interaction types. The methodology described in this work exploits the benefits of discrete event simulation to iteratively design and test technologies such as electronic patient tracking systems and allows assessment of human performance measures.