Bottleneck analysis of emergency cardiac in-patient flow in a university setting: an application of queueing theory
de Bruin, A.M.; Koole, G.M.; Visser, M.C.
Clinical and Investigative Medicine. Medecine Clinique et Experimentale 28(6): 316-317
2005
ISSN/ISBN: 0147-958X PMID: 16450621 Document Number: 593289
Capacity decisions in Dutch hospitals are generally made without the help of OR model-based analyses. For several years hospital managers have been under pressure to reduce bed capacity and increase occupancy rates in the name of operational efficiency. This strategy is questionable. Variability in arrival process and length of stay (LOS) can have a major impact on hospital operation and capacity requirements. If this variability is neglected during modeling an unrealistic and static representation of reality will emerge. Such a model, based on average numbers, is not capable of describing the complexity and dynamics of in-patient flow. Too often, management does not consider the total care chain from admission to discharge, but mainly focuses on the performance of individual units. Not surprisingly, this has often resulted in diminished patient access without any significant reduction in costs.