IDEAS home Printed from https://ideas.repec.org/a/inm/orinte/v48y2018i4p384-394.html
   My bibliography  Save this article

Allocating Emergency Beds Improves the Emergency Admission Flow

Author

Listed:
  • A. J. Thomas Schneider

    (Department of Quality & Patient Safety, Leiden University Medical Center, Leiden 2333 ZA, Netherlands; Center for Healthcare Operations Improvement and Research, University of Twente, Enschede 7500 AE, Netherlands;)

  • P. Luuk Besselink

    (ORTEC Consulting, Houston, Texas 77027)

  • Maartje E. Zonderland

    (Center for Healthcare Operations Improvement and Research, University of Twente, Enschede 7500 AE, Netherlands)

  • Richard J. Boucherie

    (Center for Healthcare Operations Improvement and Research, University of Twente, Enschede 7500 AE, Netherlands)

  • Wilbert B. van den Hout

    (Department of Medical Decision Making, Leiden University Medical Center, Leiden 2333 ZA, Netherlands)

  • Job Kievit

    (Department of Medical Decision Making, Leiden University Medical Center, Leiden 2333 ZA, Netherlands)

  • Paul Bilars

    (Department of Internal Medicine, Leiden University Medical Center, Leiden 2333 ZA, Netherlands)

  • A. Jaap Fogteloo

    (Department of Internal Medicine, Leiden University Medical Center, Leiden 2333 ZA, Netherlands)

  • Ton J. Rabelink

    (Department of Internal Medicine, Leiden University Medical Center, Leiden 2333 ZA, Netherlands)

Abstract

The increasing number of admissions to hospital emergency departments (EDs) during the past decade has resulted in overcrowded EDs and decreased quality of care. The emergency admission flow that we discuss in this study relates to three types of hospital departments: EDs, acute medical unit (AMUs), and inpatient wards. This study has two objectives: (1) to evaluate the impact of allocating beds in inpatient wards to accommodate emergency admissions and (2) to analyze the impact of pooling the number of beds allocated for emergency admissions in inpatient wards. To analyze the impact of various allocations of emergency beds, we developed a discrete event simulation model. We evaluate the bed allocation scenarios using three performance indicators: (1) the length of stay in the AMU, (2) the fraction of patients refused admission, and (3) the utilization of allocated beds. We develop two heuristics to allocate beds to wards and show that pooling beds improves performance. The partnering hospital has embedded a decision support tool based on the simulation model into its planning and control cycle. The hospital uses it every quarter and updates it with data on a 1-year rolling horizon. This strategy has substantially reduced the number of patients who are refused emergency admission.

Suggested Citation

  • A. J. Thomas Schneider & P. Luuk Besselink & Maartje E. Zonderland & Richard J. Boucherie & Wilbert B. van den Hout & Job Kievit & Paul Bilars & A. Jaap Fogteloo & Ton J. Rabelink, 2018. "Allocating Emergency Beds Improves the Emergency Admission Flow," Interfaces, INFORMS, vol. 48(4), pages 384-394, August.
    • Handle: RePEc:inm:orinte:v:48:y:2018:i:4:p:384-394
    DOI: 10.1287/inte.2018.0951
    as

    Download full text from publisher

    File URL: https://doi.org/10.1287/inte.2018.0951
    Download Restriction: no
    File URL: https://libkey.io/10.1287/inte.2018.0951?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Avishai Mandelbaum & Martin I. Reiman, 1998. "On Pooling in Queueing Networks," Management Science, INFORMS, vol. 44(7), pages 971-981, July.
    2. Eva K. Lee & Hany Y. Atallah & Michael D. Wright & Eleanor T. Post & Calvin Thomas & Daniel T. Wu & Leon L. Haley, 2015. "Transforming Hospital Emergency Department Workflow and Patient Care," Interfaces, INFORMS, vol. 45(1), pages 58-82, February.
    3. Peter Hulshof & Richard Boucherie & J. Essen & Erwin Hans & Johann Hurink & Nikky Kortbeek & Nelly Litvak & Peter Vanberkel & Egbert Veen & Bart Veltman & Ingrid Vliegen & Maartje Zonderland, 2011. "ORchestra: an online reference database of OR/MS literature in health care," Health Care Management Science, Springer, vol. 14(4), pages 383-384, November.
    4. Kyle Cattani & Glen M. Schmidt, 2005. "The Pooling Principle," INFORMS Transactions on Education, INFORMS, vol. 5(2), pages 17-24, January.
    5. A. Bruin & R. Bekker & L. Zanten & G. Koole, 2010. "Dimensioning hospital wards using the Erlang loss model," Annals of Operations Research, Springer, vol. 178(1), pages 23-43, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. David Scheinker & Margaret L. Brandeau, 2020. "Implementing Analytics Projects in a Hospital: Successes, Failures, and Opportunities," Interfaces, INFORMS, vol. 50(3), pages 176-189, May.
    2. Miguel Angel Ortíz-Barrios & Juan-José Alfaro-Saíz, 2020. "Methodological Approaches to Support Process Improvement in Emergency Departments: A Systematic Review," IJERPH, MDPI, vol. 17(8), pages 1-41, April.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Nur Sunar & Yichen Tu & Serhan Ziya, 2021. "Pooled vs. Dedicated Queues when Customers Are Delay-Sensitive," Management Science, INFORMS, vol. 67(6), pages 3785-3802, June.
    2. Hui Zhang & Thomas J. Best & Anton Chivu & David O. Meltzer, 2020. "Simulation-based optimization to improve hospital patient assignment to physicians and clinical units," Health Care Management Science, Springer, vol. 23(1), pages 117-141, March.
    3. Michael R. Miller & Robert J. Alexander & Vincent A. Arbige & Robert F. Dell & Steven R. Kremer & Brian P. McClune & Jane E. Oppenlander & Joshua P. Tomlin, 2017. "Optimal Allocation of Students to Naval Nuclear-Power Training Units," Interfaces, INFORMS, vol. 47(4), pages 320-335, August.
    4. Sigrún Andradóttir & Hayriye Ayhan & Douglas G. Down, 2001. "Server Assignment Policies for Maximizing the Steady-State Throughput of Finite Queueing Systems," Management Science, INFORMS, vol. 47(10), pages 1421-1439, October.
    5. Niyirora, Jerome & Zhuang, Jun, 2017. "Fluid approximations and control of queues in emergency departments," European Journal of Operational Research, Elsevier, vol. 261(3), pages 1110-1124.
    6. Ward Whitt, 1999. "Partitioning Customers into Service Groups," Management Science, INFORMS, vol. 45(11), pages 1579-1592, November.
    7. Yanting Chen & Jingui Xie & Taozeng Zhu, 2023. "Overflow in systems with two servers: the negative consequences," Flexible Services and Manufacturing Journal, Springer, vol. 35(3), pages 838-863, September.
    8. Alexander Hübner & Heinrich Kuhn & Manuel Walther, 2018. "Combining clinical departments and wards in maximum-care hospitals," OR Spectrum: Quantitative Approaches in Management, Springer;Gesellschaft für Operations Research e.V., vol. 40(3), pages 679-709, July.
    9. Zhao, Chen & Wang, Zhongbin, 2023. "The impact of line-sitting on a two-server queueing system," European Journal of Operational Research, Elsevier, vol. 308(2), pages 782-800.
    10. Yuta Kanai & Hideaki Takagi, 2021. "Markov chain analysis for the neonatal inpatient flow in a hospital," Health Care Management Science, Springer, vol. 24(1), pages 92-116, March.
    11. Range, Troels Martin & Kozlowski, Dawid & Petersen, Niels Chr., 2019. "Dynamic job assignment: A column generation approach with an application to surgery allocation," European Journal of Operational Research, Elsevier, vol. 272(1), pages 78-93.
    12. Wallace J. Hopp & Eylem Tekin & Mark P. Van Oyen, 2004. "Benefits of Skill Chaining in Serial Production Lines with Cross-Trained Workers," Management Science, INFORMS, vol. 50(1), pages 83-98, January.
    13. Jianpei Wen & Hanyu Jiang & Jie Song, 2019. "A Stochastic Queueing Model for Capacity Allocation in the Hierarchical Healthcare Delivery System," Asia-Pacific Journal of Operational Research (APJOR), World Scientific Publishing Co. Pte. Ltd., vol. 36(01), pages 1-24, February.
    14. Tanja Mlinar & Philippe Chevalier, 2016. "Pooling heterogeneous products for manufacturing environments," 4OR, Springer, vol. 14(2), pages 173-200, June.
    15. Jonas Ingels & Broos Maenhout, 2018. "The impact of overtime as a time-based proactive scheduling and reactive allocation strategy on the robustness of a personnel shift roster," Journal of Scheduling, Springer, vol. 21(2), pages 143-165, April.
    16. Michael Samudra & Carla Van Riet & Erik Demeulemeester & Brecht Cardoen & Nancy Vansteenkiste & Frank E. Rademakers, 2016. "Scheduling operating rooms: achievements, challenges and pitfalls," Journal of Scheduling, Springer, vol. 19(5), pages 493-525, October.
    17. Chen, Wanying (Amanda) & De Koster, René B.M. & Gong, Yeming, 2021. "Performance evaluation of automated medicine delivery systems," Transportation Research Part E: Logistics and Transportation Review, Elsevier, vol. 147(C).
    18. Seyed M. Iravani & Mark P. Van Oyen & Katharine T. Sims, 2005. "Structural Flexibility: A New Perspective on the Design of Manufacturing and Service Operations," Management Science, INFORMS, vol. 51(2), pages 151-166, February.
    19. Shuangchi He & Melvyn Sim & Meilin Zhang, 2019. "Data-Driven Patient Scheduling in Emergency Departments: A Hybrid Robust-Stochastic Approach," Management Science, INFORMS, vol. 65(9), pages 4123-4140, September.
    20. Aleksandra Marcikic Horvat & Branislav Dudic & Boris Radovanov & Boban Melovic & Otilija Sedlak & Monika Davidekova, 2020. "Binary Programming Model for Rostering Ambulance Crew-Relevance for the Management and Business," Mathematics, MDPI, vol. 9(1), pages 1-13, December.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:inm:orinte:v:48:y:2018:i:4:p:384-394. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Chris Asher (email available below). General contact details of provider: https://edirc.repec.org/data/inforea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.