Using a slotted queuing model to predict the Operational Performance of Collaborative Emergency Centres

Abstract

Nova Scotia has developed a novel way to manage Emergency Department patients in small communities during overnight hours. Using a paramedic and a RN, who are in contact with a doctor over the phone, staff are able to manage the few patients who seek emergency care overnight at these Collaborative Emergency Centres (CECs). This thesis models the operational performance of the CECs using a slotted queuing model, then considers three population levels and compares the system’s operational performance pre- and post-CEC implementation. It is found that a CEC’s success is related to the proportion of supply to demand for primary care appointments. When there are more appointments than demand for primary care, the CEC improves primary care access by increasing physician availability during daytime hours. When there is greater demand for primary care than there are appointments available, the CEC increases wait time for primary care in all population groups modelled as the CEC requires some patients to return for additional daytime care.