Modeling the effect of short stay units on patient admissions

Abstract

Two purposes of Short Stay Units (SSU) are the reduction of Emergency Department crowding and increased urgent patient admissions. At an SSU urgent patients are temporarily held until they either can go home or transferred to an inpatient ward. In this paper we present an overflow model to evaluate the effect of employing a SSU on elective and urgent patient admissions.

New Zealand’s emergency department target – did it reduce ED length of stay, and if so, how and when?

“…This increasing reliance on short-stay units also occurred in the context of significant year-on-year increases in ED presentations in three of the four case study hospitals (H2, H3, H4). Clearly, SSUs made a discernible contribution to the management of patient flows within hospitals [ 46 ]. However, it is also clear that the creation and/or expansion of SSUs provided hospitals with the means of meeting the ED target, particularly once further opportunities for process improvement became scarce.…”

“…Finally, the value of official ED target performance figures may also be problematic in the context of growing use of short-stay units (SSUs) within EDs or in other parts of the hospital. These units, (acute assessment units, observation wards), have been increasingly established and used by hospitals as part of a strategy to manage acute demand [ 45 , 46 ]. The increasing role of SSUs can be justified on clinical and organisational grounds [ 47 , 48 ].…”

Study of cost effective and stay wise use of beds in a general hospital

“…ME zonderland, RJ Boucherie et al in their study stated that short stay will increase the admission rates at the expense of decrease in number of elective admissions. 12 C storm, JS Stefansson et al in their study assessed beneficial and harmful effects of short stay unit hospitalization compared with usual care in people with internal medicine diseases and conditions. They also observed that short stay might reduce hospital admission rate, hospital duration, hospital re admission and the expenditure without compromising the quality of patient care.…”

Integral Capacity Management & Planning in Hospitals

“…For a network comprising an ED, two aggregated wards, and an AMU, the study reported in [265] determines the blocking probability by invoking a network of Erlang loss queues in which the AMU both has direct patient arrivals and serves as an overflow ward. The authors consider both urgent patients (arriving from the ED) and elective patients.…”

“…Queueing networks are useful in relating capacity levels to certain performance measures such as blocking probability. For example, the authors of [265] analyze multiple scenarios for a network with an ED, AMU and two wards, in which the acute admission unit may function as an overflow for the other three departments. They observe that with the setting they use, the arrivals of urgent patients can be increased at the cost of decreasing elective arrivals (the increase in emergency patients is greater than the decrease in elective arrivals).…”