Dynamic patient grouping and prioritization: a new approach to emergency department flow improvement

Omar M. Ashour, Gül E. Okudan Kremer

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


The demand on emergency departments (ED) is variable and ever increasing, often leaving them overcrowded. Many hospitals are utilizing triage algorithms to rapidly sort and classify patients based on the severity of their injury or illness, however, most current triage methods are prone to over- or under-triage. In this paper, the group technology (GT) concept is applied to the triage process to develop a dynamic grouping and prioritization (DGP) algorithm. This algorithm identifies most appropriate patient groups and prioritizes them according to patient- and system-related information. Discrete event simulation (DES) has been implemented to investigate the impact of the DGP algorithm on the performance measures of the ED system. The impact was studied in comparison with the currently used triage algorithm, i.e., emergency severity index (ESI). The DGP algorithm outperforms the ESI algorithm by shortening patients’ average length of stay (LOS), average time to bed (TTB), time in emergency room, and lowering the percentage of tardy patients and their associated risk in the system.

Original languageEnglish (US)
Pages (from-to)192-205
Number of pages14
JournalHealth Care Management Science
Issue number2
StatePublished - Jan 1 2016

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • General Health Professions


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