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Analyzing Discharge Strategies during Acute Care

Author

Listed:
  • Elizabeth A. Crawford
  • Pratik J. Parikh
  • Nan Kong
  • Charuhas V. Thakar

Abstract

Background. When to discharge acute care patients is a complex decision that depends on both patient- and system-level factors. Such a decision for one patient affects other patients and operations in a hospital. The key tradeoff that we analyzed was the effect of discharge timing on several emergency department (ED)-related measures and the number of readmissions. Methods . We developed a discrete-event simulation model of patient pathway through an acute care hospital that comprises an ED and several inpatient units. The effects of discharge timing on ED waiting and boarding times, ambulance diversions, leave without treatment, and readmissions were explicitly modeled. We then analyzed the impact of 1 static and 2 proactive discharge strategies on these system outcomes. Results . Our analysis indicated that although the 2 proactive discharge strategies significantly reduced ED waiting and boarding times, and several other measures, compared with the static strategy ( P

Suggested Citation

  • Elizabeth A. Crawford & Pratik J. Parikh & Nan Kong & Charuhas V. Thakar, 2014. "Analyzing Discharge Strategies during Acute Care," Medical Decision Making, , vol. 34(2), pages 231-241, February.
    • Handle: RePEc:sae:medema:v:34:y:2014:i:2:p:231-241
    DOI: 10.1177/0272989X13503500
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    Cited by:

    1. Robert Saltzman & Theresa Roeder & Judith Lambton & Lila Param & Brian Frost & Roxanne Fernandes, 2017. "The Impact of a Discharge Holding Area on the Throughput of a Pediatric Unit," Service Science, INFORMS, vol. 9(2), pages 121-135, June.
    2. Maria Hajłasz & Bożena Mielczarek, 2020. "Simulation modelling for predicting hospital admissions and bed utilisation," Operations Research and Decisions, Wroclaw University of Science and Technology, Faculty of Management, vol. 30(3), pages 5-27.

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