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Combining clinical departments and wards in maximum-care hospitals

Author

Listed:
  • Alexander Hübner

    (Technical University Munich (TUM))

  • Heinrich Kuhn

    (Catholic University of Eichstätt-Ingolstadt)

  • Manuel Walther

    (Catholic University of Eichstätt-Ingolstadt)

Abstract

Sharing bed capacity across clinical departments improves bed availability via pooling effects. This means in effect that fewer beds are required to satisfy a given service level when combining departments and wards into groups. However, this increases the complexity of tending to inpatients and therefore creates what we term pooling costs. To solve the trade-off, we suggest an integer linear programming modeling and solution approach that is designed on a generalized set partitioning problem. The approach finds the cost-minimal combination of departments and wards in a maximum-care hospital that satisfies maximum walking distance thresholds for doctors and patients. In particular, costs associated with holding the required bed capacity are minimized while also considering seasonality of weekly demand as well as personnel qualification costs and management costs incurred by combining departments and allocating pooled ward capacity to these combinations. In addition, maximum walking distances between wards and central facilities for the combinations obtained are minimized. Our modeling and solution approach was co-developed and implemented at a large German maximum-care hospital comprising 22 clinical departments. As a result, the number of beds needed to maintain a unified service level of 95% can be reduced by 3.3%, while cutting costs by 2.1%. We also perform several sensitivity analyses and show general applicability by using simulated data for generalized and very large hospital settings.

Suggested Citation

  • 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.
  • Handle: RePEc:spr:orspec:v:40:y:2018:i:3:d:10.1007_s00291-018-0522-6
    DOI: 10.1007/s00291-018-0522-6
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    References listed on IDEAS

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    1. Stefan Helber & Daniel Böhme & Farid Oucherif & Svenja Lagershausen & Steffen Kasper, 2016. "A hierarchical facility layout planning approach for large and complex hospitals," Flexible Services and Manufacturing Journal, Springer, vol. 28(1), pages 5-29, June.
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    6. Thomas J. Best & Burhaneddin Sandıkçı & Donald D. Eisenstein & David O. Meltzer, 2015. "Managing Hospital Inpatient Bed Capacity Through Partitioning Care into Focused Wings," Manufacturing & Service Operations Management, INFORMS, vol. 17(2), pages 157-176, May.
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    Cited by:

    1. Fabian Schäfer & Manuel Walther & Alexander Hübner & Heinrich Kuhn, 2019. "Operational patient-bed assignment problem in large hospital settings including overflow and uncertainty management," Flexible Services and Manufacturing Journal, Springer, vol. 31(4), pages 1012-1041, December.
    2. Fabian Schäfer & Manuel Walther & Dominik G. Grimm & Alexander Hübner, 2023. "Combining machine learning and optimization for the operational patient-bed assignment problem," Health Care Management Science, Springer, vol. 26(4), pages 785-806, December.

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