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Efficient Short-Term Allocation and Reallocation of Patients to Floors of a Hospital during Demand Surges

Thompson, Steven ; Nunez, Manuel ; Garfinkel, Robert ; Dean, Matthew D.

Operations research, 2009-03, Vol.57 (2), p.261-273 [Periódico revisado por pares]

Hanover, MD: Institute for Operations Research and the Management Sciences

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Título:
Efficient Short-Term Allocation and Reallocation of Patients to Floors of a Hospital during Demand Surges
Autor: Thompson, Steven ; Nunez, Manuel ; Garfinkel, Robert ; Dean, Matthew D.
Assuntos: Allocative efficiency ; Ambulances ; Applied sciences ; Approximation ; Biological and medical sciences ; Decision support systems ; Decision theory. Utility theory ; Economy. Management ; Emergency medical care ; Exact sciences and technology ; Firm modelling ; Flooring ; Health and social institutions ; Health care quality ; Health care waiting times ; Health maintenance organizations ; HMOs ; Hospital admissions ; Hospital beds ; Hospitals ; Length of stay ; Markov analysis ; Medical sciences ; Operational research and scientific management ; Operational research. Management science ; Operations research ; Optimization techniques ; OR Practice ; Patients ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Quality of care ; Relocation ; Staffing ; Studies ; Workforce planning
É parte de: Operations research, 2009-03, Vol.57 (2), p.261-273
Descrição: Many hospitals face the problem of insufficient capacity to meet demand for inpatient beds, especially during demand surges. This results in quality degradation of patient care due to large delays from admission time to the hospital until arrival at a floor. In addition, there is loss of revenue because of the inability to provide service to potential patients. A solution to the problem is to proactively transfer patients between floors in anticipation of a demand surge. Optimal reallocation poses an extraordinarily complex problem that can be modeled as a finite-horizon Markov decision process. Based on the optimization model, a decision-support system has been developed and implemented at Windham Hospital in Willimantic, Connecticut. Projections from an initial trial period indicate very significant financial gains of about 1% of their total revenue, with no negative impact on any standard quality of care or staffing effectiveness indicators. In addition, the hospital showed a marked improvement in quality of care because of a resulting decrease of almost 50% in the average time that an admitted patient has to wait from admission until being transferred to a floor.
Editor: Hanover, MD: Institute for Operations Research and the Management Sciences
Idioma: Inglês

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Efficient Short-Term Allocation and Reallocation of Patients to Floors of a Hospital during Demand Surges

Thompson, Steven ; Nunez, Manuel ; Garfinkel, Robert ; Dean, Matthew D.

Hanover, MD: Institute for Operations Research and the Management Sciences

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