Reducing Handoffs and Improving Patient Flow in the ED

Abstract Over 145 million people visit US Emergency Departments annually. The diverse nature and overwhelming volume of patient visits make the ED one of the most complicated healthcare settings. In particular, handoffs, the transfer of patient care from one physician to another during shift transition are a common source of errors resulting from workflow interruptions and high cognitive workload. This research focuses on developing a hybrid agent-based discrete event simulation model to identify physician shifts that minimize handoffs without affecting other performance metrics. By providing overlapping shift schedules as well as implementing policies that restrict physicians from signing up a new patient during the last hour of the shift, we observed that handoffs and patient time in the emergency department could be reduced by as much as 42% and 17%, respectively.