Nurse Staffing Management in the Context of Emergency Departments and Seasonal Respiratory Diseases: An Artificial Intelligence and Discrete-Event Simulation Approach

[EN] Emergency Departments (EDs) usually experience nursing shortages during Seasonal Respiratory Diseases (SRDs). As a result, patient waiting times for medical treatment increase with the consequent overcrowding, high intra-hospital infection rates, and no-shows. Therefore, the nurse staffing must...

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Detalles Bibliográficos
Autores: Ortiz-Barrios, Miguel, Arias-Fonseca, S., McClean, S., Perez-Aguilar, Aramando, Cuenca, L.|||0000-0003-3589-4182
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universitat Politècnica de València (UPV)
Repositorio:RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia
Idioma:inglés
OAI Identifier:oai:dnet:riunet______::e5c7fe752d03762c7b2d1bc496b68aae
Acceso en línea:https://riunet.upv.es/handle/10251/234920
Access Level:acceso embargado
Palabra clave:Artificial intelligence (AI)
Extreme gradient boosting (XGBoost)
Discrete-event-simulation (DES)
Emergency department (ED)
Nurse staffing
Seasonal respiratory diseases (SRDs)
Descripción
Sumario:[EN] Emergency Departments (EDs) usually experience nursing shortages during Seasonal Respiratory Diseases (SRDs). As a result, patient waiting times for medical treatment increase with the consequent overcrowding, high intra-hospital infection rates, and no-shows. Therefore, the nurse staffing must be balanced with the projected volume of SRD-related ED admissions to EDs. In this article, we propose merging Artificial Intelligence (AI) and Discrete-Event Simulation (DES) to build remedies that diminish the waiting times for nursing care in mild and severe respiratory-affected patients. We first implemented Extreme Gradient Boosting (XGBoost) to calculate the probability of treatment within the ED wards. Afterwards, we plugged the XGBoost predictions into a simulation model to evaluate whether the current nurse staff was sufficient to ensure the timely treatment of the expected respiratory-affected patients. Ultimately, we pretested three improvement scenarios recommended by the hospital administrators to tackle the imbalance problem. A Spanish ED was involved in the project to validate the suggested approach. The specificity of the predictive AI-based model was 95.97% (CI 95% 93.07% ¿ 97.90%), while the specificity was 82.0% (CI 95% 73.05% ¿ 88.96%). On a different tack, the positive and negative predictive scores corresponded to 87.23% (CI 95% 78.76% ¿ 93.22%) and 94.08% (95% CI 90.80% ¿ 96.45%). Furthermore, the Area Under Receiver Operator Characteristic (AU-ROC) curve was 89.00% (CI 95% 84.46% ¿ 94.78%). Ultimately, the median waiting time for respiratory support use was lessened between 0.88 and 7.51 h after using a new nurse staffing configuration.