Emergency departments (EDs) are continuously exploring opportunities to improve their efficiency. A new opportunity lies in revising the patient–physician assignment process by limiting the number of patients simultaneously assigned to a single physician, which is defined as the application of a case manager approach with limited caseloads. The potential of introducing a case manager approach with limited caseloads as a way to improve physician productivity, and consequently ED performance, is investigated by use of a discrete-event simulation model based on a real-life case study. In addition, as the case manager system is characterised by three parameters that can be customised and optimised (i.e. caseload limit, pre-assignment queueing discipline and internal queueing discipline), the impact of these parameters on the effectiveness to improve ED performance in terms of length-of-stay and door-to-doctor time is evaluated. To the best of our knowledge, this paper is the first to examine the potential of a case manager system with limited caseloads in a complex service system like a real-life ED, and to investigate the impact of the three system parameters on the results. The outcomes of the study show that performance can be improved significantly by introducing a case manager system, and that the system parameters have an impact on the effect size.

急诊部门（ED）不断探索提高效率的机会。一个新的机会在于通过限制同时分配给一位医师的患者数量来修改患者-医师的分配过程，这被定义为病例数量有限的病例管理方法的应用。通过使用基于实际案例研究的离散事件模拟模型，研究了采用案例数量有限的案例管理器方法来提高医师生产率并进而提高ED性能的潜力。另外，由于案例管理器系统的特征在于可以自定义和优化的三个参数（即案例数量限制，预分配队列规则和内部队列规则），从停留时间和门诊时间的角度，评估了这些参数对提高ED性能的有效性的影响。据我们所知，本文是第一个研究案例量有限的案例管理器系统在像现实生活ED这样的复杂服务系统中的潜力，并研究这三个系统参数对结果的影响的论文。研究结果表明，通过引入案例管理器系统可以显着提高性能，并且系统参数会对效果大小产生影响。并研究这三个系统参数对结果的影响。研究结果表明，通过引入案例管理器系统可以显着提高性能，并且系统参数对效果大小有影响。并研究这三个系统参数对结果的影响。研究结果表明，通过引入案例管理器系统可以显着提高性能，并且系统参数对效果大小有影响。