Scheduling the Hospital-Wide Flow of Elective Patients

Kolisch, Rainer; Gärtner, Daniel

doi:10.1007/978-3-319-04066-0_3

Cited by 26 publications

(38 citation statements)

References 65 publications

(16 reference statements)

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“…Simulation optimization makes it possible to obtain immediately the best value for the chosen objective from among all possibilities without explicitly evaluating each scenario [22,23]. It is therefore possible to identify which and how many additional resources are required to achieve the best values for alternative objective functions thus allowing decision makers to compare the impact of the different solutions from the patient and hospital perspectives.…”

Section: Optimization Resultsmentioning

confidence: 99%

“…Different categories of patients and CPs have been examined with respect to resource requirements. More recently, Gartner and Kolisch [22] have proposed two mixed-integer programs to plan the flow of elective patients in hospitals, taking into account scarce medical resources and aiming at maximizing the contribution margin for all patients.…”

Section: Introduction and Aim Of The Studymentioning

confidence: 99%

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Improving the performance of surgery-based clinical pathways: a simulation-optimization approach

Özcan

Tànfani

Testi

2016

Health Care Manag Sci

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This paper aims to improve the performance of clinical processes using clinical pathways (CPs). The specific goal of this research is to develop a decision support tool, based on a simulation-optimization approach, which identify the proper adjustment and alignment of resources to achieve better performance for both the patients and the health-care facility. When multiple perspectives are present in a decision problem, critical issues arise and often require the balancing of goals. In our approach, meeting patients' clinical needs in a timely manner, and to avoid worsening of clinical conditions, we assess the level of appropriate resources. The simulation-optimization model seeks and evaluates alternative resource configurations aimed at balancing the two main objectives-meeting patient needs and optimal utilization of beds and operating rooms.Using primary data collected at a Department of Surgery of a public hospital located in Genoa, Italy. The simulation-optimization modelling approach in this study has been applied to evaluate the thyroid surgical treatment together with the other surgery-based CPs. The low rate of bed utilization and the long elective waiting lists of the specialty under study indicates that the wards were oversized while the operating room capacity was the bottleneck of the system. The model enables hospital managers determine which objective has to be given priority, as well as the corresponding opportunity costs.

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Section: Optimization Resultsmentioning

confidence: 99%

Section: Introduction and Aim Of The Studymentioning

confidence: 99%

Improving the performance of surgery-based clinical pathways: a simulation-optimization approach

Özcan

Tànfani

Testi

2016

Health Care Manag Sci

View full text Add to dashboard Cite

show abstract

“…It links the work of Cardoen and Demeulemeester (2008) on the strategic decision level with clinical medical work on CP mining. From an operations management point of view, the sequential pattern mining approach presented could be used in a patient scheduling problem which is located on an operational decision level, see Gartner and Kolisch (2014).…”

Section: Generalizability Of the Resultsmentioning

confidence: 99%

“…On an operational decision level, CPs are used in a variety of patient scheduling applications (Gartner and Padman 2017). For example, Gartner and Kolisch (2014) use CPs to schedule elective patients hospital-wide on scarce resources. Their work uses elective patients' CPs as an input parameter in their models and assume that once an elective patient contacts the hospital, the pathways are fixed.…”

Section: Healthcare Operations-driven Use Of Clinical Pathwaysmentioning

confidence: 99%

Improving hospital layout planning through clinical pathway mining

Arnolds

Gärtner

2017

Ann Oper Res

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Clinical pathways (CPs) are standardized, typically evidence-based health care processes. They define the set and sequence of procedures such as diagnostics, surgical and therapy activities applied to patients. This study examines the value of data-driven CP mining for strategic healthcare management. When assigning specialties to locations within hospitals-for new hospital buildings or reconstruction works-the future CPs should be known to effectively minimize distances traveled by patients. The challenge is to dovetail the prediction of uncertain CPs with hospital layout planning. We approach this problem in three stages: In the first stage, we extend a machine learning algorithm based on probabilistic finite state automata (PFSA) to learn significant CPs from data captured in hospital information systems. In that stage, each significant CP is associated with a transition probability. A unique feature of our approach is that we can generalize the data and include those CPs which have not been observed in the data but which are likely to be followed by future patients according to the pathway probabilities obtained from the PFSA. At the same time, rare and non-significant CPs are filtered out. In the second stage, we present a mathematical model that allows us to perform hospital layout planning decisions based on the CPs, their probabilities and expert knowledge. In the third stage, we evaluate our approach based on different performance measures. Our case study results based on real-world hospital data reveal that using our CP mining approach, distances traveled by patients can be reduced substantially as compared to using a baseline method. In a second case study, when using our approach for reconstructing a hospital and incorporating expert knowledge into the planning, existing layouts can be improved. B Daniel Gartner

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“…[254] create treatment schedules on a week level, to be specified later in terms of morning/afternoon appointments and time slots. Scheduling a series of procedures in care chains for inpatients, such as diagnostic activities and surgery, in a several week horizon is done in order to maximize the contribution margin [106], to minimize the length of stay [265] or in a day horizon to minimize waiting times and overtime [148,313]. Series of examinations for vascular checkups are scheduled in [76], either on one day or on multiple days, for inpatients as well as outpatients.…”

Section: Capacity-to-patient Assignmentmentioning

confidence: 99%

Organizing integrated processes in cancer care

Leeftink¹

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Scheduling the Hospital-Wide Flow of Elective Patients

Cited by 26 publications

References 65 publications

Improving the performance of surgery-based clinical pathways: a simulation-optimization approach

Improving the performance of surgery-based clinical pathways: a simulation-optimization approach

Improving hospital layout planning through clinical pathway mining

Organizing integrated processes in cancer care

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