Design and Optimization Methods for Elective Hospital Admissions

Jonathan E. Helm () and Mark P. Van Oyen ()
Additional contact information
Jonathan E. Helm: Department of Operations and Decision Technologies, Kelley School of Business, Indiana University, Bloomington, Indiana 47405
Mark P. Van Oyen: Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, Michigan 48109

Operations Research, 2014, vol. 62, issue 6, 1265-1282

Abstract: Hospitals typically lack effective enterprise level strategic planning of bed and care resources, contributing to bed census levels that are statistically “out of control.” This system dysfunction manifests itself in bed block, surgical cancelation, ambulance diversions, and operational chaos. This is the classic hospital admission scheduling and control (HASC) problem, which has been addressed in its entirety only through inexact simulation-based search heuristics. This paper develops new analytical models of controlled hospital census that can, for the first time, be incorporated into a mixed-integer programming model to optimally solve the strategic planning/scheduling portion of the HASC. Our new solution method coordinates elective admissions with other hospital subsystems to reduce system congestion. We formulate a new Poisson-arrival-location model (PALM) based on an innovative stochastic location process that we developed and call the patient temporal resource needs model. We further extend the PALM approach to the class of deterministic controlled-arrival-location models (d-CALM) and develop linearizing approximations to stochastic blocking metrics. This work provides the theoretical foundations for an efficient scheduled admissions planning system as well as a practical decision support methodology to stabilize hospital census.

Keywords: hospital admissions and bed management; stochastic patient flow modeling; mixed-integer programming; census smoothing; stochastic arrival-location models (search for similar items in EconPapers)
Date: 2014
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (18)

Downloads: (external link)
http://dx.doi.org/10.1287/opre.2014.1317 (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:inm:oropre:v:62:y:2014:i:6:p:1265-1282

Access Statistics for this article

More articles in Operations Research from INFORMS Contact information at EDIRC.
Bibliographic data for series maintained by Chris Asher ().