A simulation-based approach to analysing delays in the transport of critically ill neonates

Lun Li, Viveka Saraiya, Rachel A. Umoren, Matthew W. Cook, Taylor L. Sawyer and Prashanth Rajivan

Health Systems, 2025, vol. 14, issue 1, 69-84

Abstract: Neonatal interfacility transport ensures that critically ill neonatal patients can receive higher levels of care when needed. Delays in the transport process impact the quality of care and increase the risk of medical complications. The objective of this study is to investigate the operations-related factors that contribute to transport delays and explore the role of discrete-event simulation in improving the transport process. Semi-structured interviews were conducted with stakeholders to understand the neonatal interfacility transport process. Analysis of historical call logs and transport data was performed to identify inputs to the discrete-event simulation model. Statistical tests were used to identify the effect of various factors on wait time and transport time in the simulation model. High patient volume and limited bed capacity at the receiving hospitals are identified as bottlenecks that lead to extended wait time and transportation time. Additionally, having more geographically distributed ambulance resources does not significantly help with the time delays when the receiving hospital capacity stays unchanged. Discrete-event simulation models can be used to investigate the effects of operations-related factors in the interfacility transport of critically ill neonates to support future process improvement.

Date: 2025
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DOI: 10.1080/20476965.2024.2391740

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