Agent-oriented simulation of Emergency Department re-triage based on allocated time to treatment

Triage is the first point of clinical assessment of severity in Emergency Departments (ED). While patients are allocated maximum waiting time to treatment, it is often overlooked in Malaysian ED. There are situations when patients´ clinical conditions have deteriorated while waiting for treatment, which the patients may not have realized. Ideally, as patients reach the allocated waiting time limit, they should be re-triaged in order to re-assess their severity and take action for prompt treatment if necessary. Since, existing Malaysian triage systems do not implement re-triage, we used agent-oriented simulation to study the effects of re-triage on patients with deteriorating clinical conditions. Our preliminary findings show that re-triage can help to reduce the waiting time of patients whose conditions deteriorate rapidly. The simulation also uncovers an ED resource bottleneck, i.e., the number of physicians treating the patients, which is fixed to two based on the advice of practitioners.