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Optimal Assignment of Patients from Emergency Department to Inpatient Hospital Wards

Shakeri, Mahdi | 2019

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  1. Type of Document: M.Sc. Thesis
  2. Language: Farsi
  3. Document No: 52055 (01)
  4. University: Sharif University of Technology
  5. Department: Industrial Engineering
  6. Advisor(s): Haji, Babak
  7. Abstract:
  8. Emergency Department (ED) overcrowding is one the most problems and challenges that every Emergency Department all over the world is facing with. This problem leads to some problems like prolonged waiting times and Length of Stay in Emergency Department. “Boarding time” is one of the most important ones, which is the time a patient spend for being transferred from Emergency Department to one of the Hospital Inpatient Wards. One important solution to this problem is “overflowing”, and it means allocating patients to an alternative ward rather than their primary ward. In practice, the overflowing process usually controlled in a myopic manner. Limited number of researches that focus in this area usually have developed complex algorithms which are hard to implement in EDs. The main goal of this research is to find an efficient, practical overflowing strategy. To this end, first, a system with small size (including two inpatient wards) named “basic model” is studied. In this section, Queueing Theory approaches is utilized in order to find average length of queue for various overflowing strategies and to select one of those. For determining average length of queue in such model, two approaches—solving steady state equations as well as determining probability-generating function—are utilized. Then, a system with bigger size (including more than two inpatient wards) named “generalized model” is studied. In this section, a number of heuristic algorithms are proposed based on factors from principles of flexibility in manufacturing systems. To this end, insights from studying basic model, and also some concepts of Graph Theory as well as Optimization are utilized. In the end, the performance of these algorithms is analyzed by simulating different scenarios. The results show that utilizing an efficient, practical overflowing strategy can dramatically reduce the Boarding time while maintain quality of care in an acceptable level
  9. Keywords:
  10. Emergency Department Overcrowing ; Waiting Time ; Boarding Time ; Overflowing ; Queuing Theory ; Optimum Allocation

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