الفهرس 
A simulation based study for improving emergency department performance during overcrowding
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Abstract
The current study proposes a methodology that combines six - sigma with computer - based simulation to analyze and direct improvement decisions that target the reduction of overcrowding in ED. The six sigma methodology, based on the define, measure, analyze, Improve, and control (DMAIC) format, is used to analyze the ED overcrowding problem. Simulation is used as a tool for implementing the analyze and Improve{u2016} phases of the six - sigma methodology; where it is used to identify, evaluate and recommend potential measures to reduce ED overcrowding and study the effect of medical equipment availability, breakdown and technology on ED performance. A case study is presented to demonstrate the proposed methodology, and to show its effectiveness in proposing resource and process based modifications that can significantly reduce overcrowding, and consequently increase patient throughput and reduce length of stay