Modeling Patient Flows Through the Healthcare System

Hall, Randolph W.; Belson, David; Murali, Pavan; Dessouky, Maged

doi:10.1007/978-0-387-33636-7_1

Cited by 87 publications

(88 citation statements)

References 10 publications

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“…However, operations research methods alone are not sufficient to resolve all the flaws in the transport system. Improvements can only be achieved by streamlining work 20 processes and increasing awareness among hospital staff about the importance of implementing efficient logistics practices, Hall et al (2006). Opti-TRANS c is a transport planning system that has been designed to support all phases of the transportation flow, ranging from request booking, scheduling, dispatching to monitoring and reporting.…”

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confidence: 99%

Bringing Robustness to Patient Flow Management Through Optimized Patient Transports in Hospitals

Melo²,

2009

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Intra-hospital transports are often required for diagnostic or therapeutic reasons. Depending on the hospital layout, transportation between nursing wards and service units is either provided by ambulances or by trained personnel who accompany patients on foot. In many large German hospitals, the patient transport service is poorly managed and lacks workflow coordination. This contributes to higher hospital costs (e.g. when a patient is not delivered to the operating room on time) and to patient inconvenience due to longer waiting times. We have designed a computer-based planning systemOpti-TRANS c -that supports all phases of the transportation flow, ranging from travel booking, dispatching transport requests to monitoring and reporting trips in real-time.The methodology developed to solve the underlying optimization problem -a dynamic dial-a-ride problem with hospital-specific constraints -draws on fast heuristic methods to * Corresponding author.1 ensure the efficient and timely provision of transports. We illustrate the strong impact of Opti-TRANS c on the daily performance of the patient transportation service of a large German hospital. The major benefits obtained with the new tool include streamlined transportation processes and workflow, significant savings and improved patient satisfaction. Moreover, the new planning system has contributed to increase awareness among hospital staff about the importance of implementing efficient logistics practices.Medical diagnostic facilities and treatment units are among the most daily visited departments of a hospital, both by inpatients and outpatients. In particular, inpatients with limited mobility are accompanied by trained staff from and to these service areas. If intra-hospital movement is required between health care units within the same building then patients are pushed on gurneys, beds or wheelchairs. In campus-based hospitals, inter-building transportation is provided by appropriate vehicles, mostly ambulances, which can be shared by several patients.The organization and provision of intra-hospital transportation for patients, as well as for supplies and equipment, are among the daily logistics activities conducted in a hospital. Although these ancillary services seem simple and straightforward, they impact significantly on the quality of health care and on hospital costs. For example, the late delivery of a patient to a high cost service facility, such as an operating theater or a magnetic resonance imaging department, leads to the underutilization of valuable (staff and equipment) resources. In addition, it disrupts the initially planned schedules of these units. On the other hand, missing an appointment often results in extended waiting time for the patient or even in rescheduling the appointment, thus impacting negatively on patient satisfaction.Despite its importance, the role played by logistics is often overlooked by health care organizations. A recent study by Landry and Philippe (2004) has revealed that logistics related activities account...

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confidence: 99%

Bringing Robustness to Patient Flow Management Through Optimized Patient Transports in Hospitals

Melo²,

2009

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“…The mismatch between capacity and demand can arise both because of the inherent variation in the patient flow and also because of inadequate resource planning. According to Hall et al (2006), successful work in reducing delays depends on collaboration between administrative and clinical processes, ability to see health care as a system and find bottlenecks and system failures in patient flows.…”

Section: Hospital Resource Planningmentioning

confidence: 99%

Towards Increased Use of Discrete-Event Simulation for Hospital Resource Planning

Steins¹

2017

Linköping Studies in Science and Technology. Dissertations

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Health care systems in many countries are experiencing a growing demand while their resources remain limited. The discrepancy between demand and capacity creates many problems -long waiting times for treatment, overcrowding in hospital wards, high workload, etc. More efficient delivery of health care services can be achieved by better planning of its resources so that the mismatch between demand and capacity is minimized. Planning health care resources, including hospital resources, is difficult due to system complexity and variability in both resource availability and demand. Discrete-event simulation and other operational research methods can be used for solving planning problems in health care, and have been gaining increased attention from researchers during recent decades. Despite the growing number of academic publications, simulation appears to be less used in health care than in other application areas and only a small proportion of simulation studies is actually implemented.The aim of this thesis is to contribute to increased use of discrete-event simulation in hospital resource planning. The separate studies regarding intensive care unit capacity planning, operating room allocation strategies and the management of emergency patient flow in a radiology department highlight both the possibilities and the requirements for practical application of discrete-event simulation in hospital resource planning. The studies are described in five papers.In the first paper, the relationship between intensive care unit (ICU) occupancy and patient outcomes was investigated and the results showed that risk adjusted mortality was higher in the group of patients who were treated during high levels of occupancy. This indicates that appropriate planning of ICU resources is necessary to avoid adverse effects on patient outcomes.In the second paper, analysis of a relatively simple care chain consisting of two hospital departments -emergency and radiology -revealed a process that was not very well defined and measured. Investigation into data availability uncovered disparate information systems storing incompatible and fragmented data. It suggests that the current degree of process orientation and the current IT infrastructure does not enable efficient use of quantitative process analysis and management tools such as simulation.In the third paper, the value and possibilities of using simulation modelling in hospital resource planning were examined through the development and use of a simulation model for improved operating room time allocation and patient flow in a hospital operating department. The model was initially used for studying overcrowding in a post-anaesthesia care unit. Advanced planning logic implemented in the model enabled evaluation of several different scenarios aiming to improve the utilization of operating room resources. The results showed that it is possible to achieve slightly better and more even resource utilization, as well as provide greater flexibility in scheduling operations.In the fourth p...

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“…The study of healthcare delay is an application of the discipline of queuing theory [18]. Health care is similar to other forms of queuing in these respects: the demand for service is in part predictable (e.g., result of time-of-day patterns) and in part random, health services require coordination of multiple resources, such as physicians, medications, and diagnostic equipment, services are provided in multiple steps, through a network of services, delays can be reduced through careful forecasting, scheduling, and process improvement and information management.…”

Section: Literature Reviewmentioning

confidence: 99%