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Modelling length of stay and patient flows: methodological case studies from the UK neonatal care services

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  • Eren Demir

    (University of Hertfordshire, Hertfordshire, UK)

  • Reda Lebcir

    (University of Hertfordshire, Hertfordshire, UK)

  • Shola Adeyemi

    (University of Westminster, London, UK)

Abstract

The number of babies needing neonatal care is increasing mainly because of technological and therapeutic advances. These advances have implied a decreasing neonatal mortality rate for low birth weight infants and also a falling incidence of preterm stillbirth. Given the structural changes in the National Health Service in England, coupled with recession and capacity constraints, the neonatal system is facing some serious challenges, such as nurse shortages and the lack of cots, which could inevitably impact neonates’ length of stay, and the performance of the system as a whole. These constraints have forced neonatal managers to better understand their organisation and operations in order to optimise their systems. As a result, we have developed three unique methodologies based on length of stay modelling, physical patient pathways, and system dynamics modelling. This paper evaluates these techniques applied to neonatal services in London and showcases their usefulness and implications in practice, particularly focusing on patient flow to determine major drivers of the system, which could reduce inefficiencies, improve patient experience, and reduce cost.

Suggested Citation

  • Eren Demir & Reda Lebcir & Shola Adeyemi, 2014. "Modelling length of stay and patient flows: methodological case studies from the UK neonatal care services," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 65(4), pages 532-545, April.
    • Handle: RePEc:pal:jorsoc:v:65:y:2014:i:4:p:532-545
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    Citations

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    Cited by:

    1. Azcarate, Cristina & Esparza, Laida & Mallor, Fermin, 2020. "The problem of the last bed: Contextualization and a new simulation framework for analyzing physician decisions," Omega, Elsevier, vol. 96(C).
    2. Shola Adeyemi & Eren Demir, 2020. "Modelling the neonatal system: A joint analysis of length of stay and patient pathways," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(3), pages 704-717, May.
    3. Josephine Varney & Nigel Bean & Mark Mackay, 2019. "The self-regulating nature of occupancy in ICUs: stochastic homoeostasis," Health Care Management Science, Springer, vol. 22(4), pages 615-634, December.
    4. Chih‐Tung Hsiao & Chun‐Cheng Chen & Lee‐Kai Lin & Chung‐Shu Liu, 2023. "A systems view of responding to the COVID‐19 pandemic: A causal loop model for Taiwan's approach," Systems Research and Behavioral Science, Wiley Blackwell, vol. 40(1), pages 194-206, January.
    5. Jie Bai & Andreas Fügener & Jan Schoenfelder & Jens O. Brunner, 2018. "Operations research in intensive care unit management: a literature review," Health Care Management Science, Springer, vol. 21(1), pages 1-24, March.
    6. Reda Lebcir & Rifat Atun, 2021. "Resources management impact on neonatal services performance in the United Kingdom: A system dynamics modelling approach," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(3), pages 793-812, May.
    7. 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.

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