Utilizing Partial Flexibility to Improve Emergency Department Flow : Theory and Implementation
Emergency Departments (EDs) typically have multiple areas where patients of different acuity levels receive treatments. In practice, different areas often operate with fixed nurse staffing levels. When there are substantial imbalances in congestion among different areas, it could be beneficial to deviate from the original assignment and reassign nurses. However, reassignments typically are only feasible at the beginning of 8-12-hour shifts, providing partial flexibility in adjusting staffing levels. In this work, we propose a stochastic queueing network model of patient flow in the ED and study an associated fluid control problem to guide the reassignment decision for two types of nursing staff. We propose a heuristic solution approach and investigate its performance both analytically and using simulation. We further implement the staffing approach at a large ED and conduct a statistical analysis of the before and after implementation data. Analytical results and simulation experiments suggest a significant reduction of waiting times in parameter regimes relevant to the ED setting. Empirically, we find that our staffing approach is associated with significant improvements to patient flow including a reduction in total ED length-of-stay (LOS) of up to 2.5 hours. Sensitivity analysis and robustness checks suggest that our results are likely robust to model specifications and potential biases introduced by unobserved confounders
Year of publication: |
[2022]
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Authors: | Chan, Carri W. ; Sarhangian, Vahid ; Talwai, Prem ; gogia, kriti |
Publisher: |
[S.l.] : SSRN |
Saved in:
freely available
Extent: | 1 Online-Ressource (47 p) |
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Type of publication: | Book / Working Paper |
Language: | English |
Notes: | Nach Informationen von SSRN wurde die ursprüngliche Fassung des Dokuments January 6, 2022 erstellt |
Other identifiers: | 10.2139/ssrn.4002563 [DOI] |
Source: | ECONIS - Online Catalogue of the ZBW |
Persistent link: https://www.econbiz.de/10013309012
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