Figure 1

Influence of sequential and parallel care processes on the number of occupied treatment rooms. Legend: We have 2 doctors both treating 3 patients, who respectively require 2, 3 and 4 care steps of 1 time unit. Both doctors need the same time to complete all 3 care processes (9 time units), but the doctor who uses patient rooms more sequentially occupies less treatment rooms at the same time (on average 1.44 vs. 1.89). With a more sequential use of treatment rooms we refer to a treatment process where the doctor completes as many activities as possible at once by one patient, then in the time he has to wait (for instance for test results) starts treating another patient, and then as soon as possible finishes the treatment process of the first patient. Even in this small example we see the effect on ED patient flow. The mean patient LOS for the first doctor equals 4.33 time units, and the mean waiting time is 1.33 time units. For the second doctor, the mean LOS is 5.67 time units and the mean waiting time equals 2.67 time units. The broad education of emergency physicians allows them to select patients from a larger group than the internists, and follow a work routine which is more like the first doctor.