Publication
Title
Inpatient boarding in emergency departments : impact on patient delays and system capacity
Author
Abstract
This study seeks insights into the impact of inpatient boarding on emergency department (ED) congestion and capacity. To do so, we model the ED as a semi-open queueing network (SOQN) with limited resources (physicians and beds) and discontinuous patient service. We present a Markov-modulated fluid queue approach to efficiently calculate service levels, and show that boarding may cause the (expensive) physician resources to be starved, especially when the bed utilization is high. While the expected number of boarding patients has a primary impact on performance, we show that there is a secondary impact stemming from the expected boarding time and the boarding probability. Boarding reduction policies perform better if they focus on reducing expected boarding time instead of the decreasing probability of boarding. Our analysis and insights are applicable also to other SOQN settings where entities require more than one resource simultaneously (e.g., intensive care units, manufacturing systems, warehousing and transportation systems). (C) 2018 Elsevier B.V. All rights reserved.
Language
English
Source (journal)
European journal of operational research. - Amsterdam
Publication
Amsterdam : 2018
ISSN
0377-2217
Volume/pages
271:3(2018), p. 953-967
ISI
000442060500014
Full text (Publisher's DOI)
Full text (publisher's version - intranet only)
UAntwerpen
Faculty/Department
Research group
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identification
Creation 08.10.2018
Last edited 15.09.2021
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