Physician shift behavior and its impact on service performances in an emergency department

Simulating detailed flow through emergency departments (ED) has been a long-standing issue. By studying the behavior of the bottleneck resource, the physicians, we have identified key factors to include in a simulation that have allowed us to create an extremely accurate model of a specific ED. The impact of these factors was evaluated through several performance measures in the ED. We conclude that it is important to consider the inclusion of physician behaviors when simulating ED wait times.