Allocating Emergency Beds Improves the Emergency Admission Flow

A.J. Thomas Schneider (Corresponding Author), P. Luuk Besselink, Maartje E. Zonderland, Richard J. Boucherie, Wilbert B. van den Hout, Job Kievit, Paul Bilars, A. Jaap Fogteloo, Ton J. Rabelink

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Abstract

The increasing number of admissions to hospital emergency departments (EDs) during the past decade has resulted in overcrowded EDs and decreased quality of care. The emergency admission flow that we discuss in this study relates to three types of hospital departments: EDs, acute medical unit (AMUs), and inpatient wards. This study has two objectives: (1) to evaluate the impact of allocating beds in inpatient wards to accommodate emergency admissions and (2) to analyze the impact of pooling the number of beds allocated for emergency admissions in inpatient wards. To analyze the impact of various allocations of emergency beds, we developed a discrete event simulation model. We evaluate the bed allocation scenarios using three performance indicators: (1) the length of stay in the AMU, (2) the fraction of patients refused admission, and (3) the utilization of allocated beds. We develop two heuristics to allocate beds to wards and show that pooling beds improves performance. The partnering hospital has embedded a decision support tool based on the simulation model into its planning and control cycle. The hospital uses it every quarter and updates it with data on a 1-year rolling horizon. This strategy has substantially reduced the number of patients who are refused emergency admission.
Original languageEnglish
Pages (from-to)291-397
JournalInterfaces
Volume48
Issue number4
DOIs
Publication statusPublished - 12 Sep 2018

Fingerprint

Emergency
Emergencies
Hospital Emergency Service
Inpatients
Medical departments (industrial plants)
Hospital Departments
Hospital beds
Pooling
Discrete event simulation
Acute
Quality of Health Care
Patient Admission
Simulation Model
Quality of Care
Length of Stay
Planning
Unit
Performance Indicators
Admission
Evaluate

Keywords

  • Acute Medical Unit
  • Emergency Department
  • Inpatient wards
  • Hospitals
  • Emergency admissions
  • Systems optimalization
  • Discrete-event simulation
  • Length of stay
  • Operations efficiency
  • Decision support

Cite this

Schneider, A.J. Thomas ; Besselink, P. Luuk ; Zonderland, Maartje E. ; Boucherie, Richard J. ; van den Hout, Wilbert B. ; Kievit, Job ; Bilars, Paul ; Fogteloo, A. Jaap ; Rabelink, Ton J. / Allocating Emergency Beds Improves the Emergency Admission Flow. In: Interfaces. 2018 ; Vol. 48, No. 4. pp. 291-397.
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abstract = "The increasing number of admissions to hospital emergency departments (EDs) during the past decade has resulted in overcrowded EDs and decreased quality of care. The emergency admission flow that we discuss in this study relates to three types of hospital departments: EDs, acute medical unit (AMUs), and inpatient wards. This study has two objectives: (1) to evaluate the impact of allocating beds in inpatient wards to accommodate emergency admissions and (2) to analyze the impact of pooling the number of beds allocated for emergency admissions in inpatient wards. To analyze the impact of various allocations of emergency beds, we developed a discrete event simulation model. We evaluate the bed allocation scenarios using three performance indicators: (1) the length of stay in the AMU, (2) the fraction of patients refused admission, and (3) the utilization of allocated beds. We develop two heuristics to allocate beds to wards and show that pooling beds improves performance. The partnering hospital has embedded a decision support tool based on the simulation model into its planning and control cycle. The hospital uses it every quarter and updates it with data on a 1-year rolling horizon. This strategy has substantially reduced the number of patients who are refused emergency admission.",
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Schneider, AJT, Besselink, PL, Zonderland, ME, Boucherie, RJ, van den Hout, WB, Kievit, J, Bilars, P, Fogteloo, AJ & Rabelink, TJ 2018, 'Allocating Emergency Beds Improves the Emergency Admission Flow', Interfaces, vol. 48, no. 4, pp. 291-397. https://doi.org/10.1287/inte.2018.0951

Allocating Emergency Beds Improves the Emergency Admission Flow. / Schneider, A.J. Thomas (Corresponding Author); Besselink, P. Luuk; Zonderland, Maartje E.; Boucherie, Richard J.; van den Hout, Wilbert B. ; Kievit, Job; Bilars, Paul; Fogteloo, A. Jaap; Rabelink, Ton J.

In: Interfaces, Vol. 48, No. 4, 12.09.2018, p. 291-397.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Allocating Emergency Beds Improves the Emergency Admission Flow

AU - Schneider, A.J. Thomas

AU - Besselink, P. Luuk

AU - Zonderland, Maartje E.

AU - Boucherie, Richard J.

AU - van den Hout, Wilbert B.

AU - Kievit, Job

AU - Bilars, Paul

AU - Fogteloo, A. Jaap

AU - Rabelink, Ton J.

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PY - 2018/9/12

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N2 - The increasing number of admissions to hospital emergency departments (EDs) during the past decade has resulted in overcrowded EDs and decreased quality of care. The emergency admission flow that we discuss in this study relates to three types of hospital departments: EDs, acute medical unit (AMUs), and inpatient wards. This study has two objectives: (1) to evaluate the impact of allocating beds in inpatient wards to accommodate emergency admissions and (2) to analyze the impact of pooling the number of beds allocated for emergency admissions in inpatient wards. To analyze the impact of various allocations of emergency beds, we developed a discrete event simulation model. We evaluate the bed allocation scenarios using three performance indicators: (1) the length of stay in the AMU, (2) the fraction of patients refused admission, and (3) the utilization of allocated beds. We develop two heuristics to allocate beds to wards and show that pooling beds improves performance. The partnering hospital has embedded a decision support tool based on the simulation model into its planning and control cycle. The hospital uses it every quarter and updates it with data on a 1-year rolling horizon. This strategy has substantially reduced the number of patients who are refused emergency admission.

AB - The increasing number of admissions to hospital emergency departments (EDs) during the past decade has resulted in overcrowded EDs and decreased quality of care. The emergency admission flow that we discuss in this study relates to three types of hospital departments: EDs, acute medical unit (AMUs), and inpatient wards. This study has two objectives: (1) to evaluate the impact of allocating beds in inpatient wards to accommodate emergency admissions and (2) to analyze the impact of pooling the number of beds allocated for emergency admissions in inpatient wards. To analyze the impact of various allocations of emergency beds, we developed a discrete event simulation model. We evaluate the bed allocation scenarios using three performance indicators: (1) the length of stay in the AMU, (2) the fraction of patients refused admission, and (3) the utilization of allocated beds. We develop two heuristics to allocate beds to wards and show that pooling beds improves performance. The partnering hospital has embedded a decision support tool based on the simulation model into its planning and control cycle. The hospital uses it every quarter and updates it with data on a 1-year rolling horizon. This strategy has substantially reduced the number of patients who are refused emergency admission.

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KW - Inpatient wards

KW - Hospitals

KW - Emergency admissions

KW - Systems optimalization

KW - Discrete-event simulation

KW - Length of stay

KW - Operations efficiency

KW - Decision support

U2 - 10.1287/inte.2018.0951

DO - 10.1287/inte.2018.0951

M3 - Article

VL - 48

SP - 291

EP - 397

JO - Interfaces

JF - Interfaces

SN - 0092-2102

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ER -