Simulation of the Emergency Department Care Process for Pediatric Traumatic Brain Injury

Ali Ajdari, Linda Ng Boyle, Nithya Kannan, Jin Wang, Frederick P. Rivara, Monica S. Vavilala

Research output: Contribution to journalArticlepeer-review


The treatment of patients in the emergency department (ED) with severe pediatric traumatic brain injury (TBI) is challenging, and treatment process strategies that facilitate good outcomes are not well documented. The overall objective of this study was to identify factors that can affect the care process associated with pediatric TBI. This objective was achieved using a discrete-event simulation model of patients with TBI as they progress through the ED treatment process of a Level I trauma center. This model was used to identify areas where the ED length of stay can be reduced. The number of patients arriving at any given time was also varied in the simulation model to observe the impact to bed allocation policies and changes in staff and equipment. The findings showed that implementing changes in the ED (i.e., availability of two computerized tomography scanners, formation of resuscitation teams that included eight staff personnel, and modifying the bed allocation policy) could result in a 17% reduction in the mean ED length of stay. The study outcomes would be of interest to those (e.g., health administrators, health managers, and physicians) who can make decisions related to the treatment process in an ED.

Original languageEnglish (US)
Pages (from-to)110-118
Number of pages9
JournalJournal of quality assurance : a publication of the National Association of Quality Assurance Professionals
Issue number2
StatePublished - Mar 1 2018


  • emergency department
  • pediatric traumatic brain injury
  • simulation model

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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