Load balancing at Emergency Departments using ‘crowdinforming’

Emergency Department overcrowding is an important healthcare issue garnering significant public and regulatory scrutiny in Canada and around the world. Many approaches to alleviate excessive waiting times and lengths of stay have been considered and implemented to various degrees. In theory, a more optimal emergency department patient flow may be assisted via balancing patient loads between emergency departments within the region - in essence spreading patients more evenly throughout this system. This investigation uses available data for one regional health authority, and utilizes simulation to explore a process control strategy built on `crowdinforming´, aimed to balance patient loads between six Emergency Departments within a mid-sized Canadian city. The preliminary model uses patient arrival rates as an indicator of `busyness´ and as the basis for crowdinforming. Intuitively expected metrics such as the number of patients waiting, the average length of stay, and time waiting to be seen were not found to be meaningful metrics of emergency department `busyness´ with this particular data set for the purpose of a process control strategy.