Aplicação de Teoria das Filas para avaliação de desempenho em uma unidade de Pronto Atendimento pediátrico

Abstract

Queues are a constant reality in emergency services due to the unpredictable nature of this environment. Studying the behavior of the queues becomes a valuable tool for companies, since the formation of queues in an Emergency Room (ER) for a prolonged period can be considered as an indication of inefficient performance and can also contribute to the worsening of heath conditions, patient dissatisfaction and overload of health professionals. The objective of this study is to evaluate, through the application of concepts related to Queuing Theory, the performance of the care process in a pediatric emergency care unit. The research developed is a case study of an applied nature, with descriptive and exploratory objectives, following a combined approach. The mapping and modeling of the process “From token removal to the end of emergency treatment in a pediatric ER” was carried out. From the analysis of the process, it was identified that 69% of the waiting time from withdrawing the token to the start of medical care, refers to the waiting time from the completion of the triage to the start of medical care. Thus, it was defined that the focus of the performance analysis would be the medical care process. For this, dashboards were built for the application of performance measures, derived from Queuing Theory, namely: average arrival rate (𝜆), average interval between arrivals (AI), average rate of attendance per doctor (μ), number minimum number of servers (i), server utilization rate (ρ), average service time (TS) and average time spent in queue (ST). From the results achieved, it was possible to analyze the balance of the medical scale, the initial scenario found that of the 728 shifts analyzed, 277 operated with a utilization rate below 50%, 211 above 100%, 193 between 100% to 80%, and 97 between 80% to 50%. With balancing, no shift would have a utilization rate above 100%, 465 shifts would have both 80% and 100% utilization, 232 between 80% to 50%, and only 31 with less than 50%. Therefore, proved that it is possible to strategically dimension the on-duty workers per shift, to avoid overloading the system and more efficiently distribute idle moments. In addition, an analysis was carried out on how many more and less shifts would be needed by swing shift, projecting savings between R$ 192,653.33 to R$ 287,229.12 for the company, considering the six months analyzed.