The decrease of ED patient boarding by implementing a stock management policy in hospital admissions

IF 3.7 4区 管理学 Q2 OPERATIONS RESEARCH & MANAGEMENT SCIENCE
Sebastián Jaén
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引用次数: 0

Abstract

The presence of congestion is a common scenario in tertiary-level hospitals worldwide. Current research suggests that an increase in hospital bed capacity is not a long-term solution given that patient demand adapts to added capacity. Recent literature suggests the need for the implementation of a policy of inter-hospital transfers to divert patients to outpatient priority services or home care. This policy has proven to be effective in reducing ED boarding without compromising patient safety. However, determining the required number of patients to be admitted is key. The dynamic nature of hospital bed availability and discharges requires an admission process able to be in synchrony with those variations. A mismatch between patient demand and hospital admissions will result in either ED boarding or idle capacity. The purpose of this paper is to introduce a methodology to support the process of hospital admissions by providing as an input a threshold for the number of patients to be admitted. The methodology is tested using a system dynamics model that replicates one year of operations of a tertiary-level hospital. The simulations reveal the potential of the methodology to decrease the ED inpatient boarding rate as well as ED and hospital length of stay.

通过在入院时实施库存管理政策,减少急诊室病人的登机人数
拥堵是全球三级医院的普遍现象。目前的研究表明,增加医院床位并不是长久之计,因为病人的需求会适应增加的床位。最近的文献表明,有必要实施医院间转院政策,将病人分流到门诊优先服务或家庭护理。事实证明,这一政策能有效减少急诊室的住院人数,同时又不影响患者的安全。然而,确定需要收治的病人数量是关键。医院床位供应和出院情况的动态性质要求入院流程能够与这些变化保持同步。如果病人需求与医院收治人数不匹配,就会导致急诊室住院人数过多或容量闲置。本文旨在介绍一种方法,通过提供待收治病人数量的阈值作为输入,支持医院的收治流程。本文使用一个系统动力学模型对该方法进行了测试,该模型复制了一家三级医院一年的运营情况。模拟结果表明,该方法有可能降低急诊室住院病人寄宿率,缩短急诊室和医院的住院时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Operations Research Perspectives
Operations Research Perspectives Mathematics-Statistics and Probability
CiteScore
6.40
自引率
0.00%
发文量
36
审稿时长
27 days
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