Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/28465
Title: Inpatient boarding in emergency departments: Impact on patient delays and system capacity
Authors: Carmen, Raisa
VAN NIEUWENHUYSE, Inneke 
Van Houdt, Benny
Issue Date: 2018
Publisher: ELSEVIER SCIENCE BV
Source: EUROPEAN JOURNAL OF OPERATIONAL RESEARCH, 271(3), p. 953-967
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.
Notes: [Carmen, Raisa; Van Nieuwenhuyse, Inneke] Katholieke Univ Leuven, Dept Decis Sci & Informat Management, Res Ctr Operat Management, Naamsestr 69, B-3000 Leuven, Belgium. [Van Nieuwenhuyse, Inneke] Hasselt Univ, Res Grp Logist, Agoralaan Bldg D, B-3590 Diepenbeek, Belgium. [Van Houdt, Benny] Univ Antwerp, Dept Math & Comp Sci, Antwerp, Belgium.
Keywords: OR in health services; Markov-modulated fluid queue; Emergency department; Inpatient boarding
Document URI: http://hdl.handle.net/1942/28465
ISSN: 0377-2217
e-ISSN: 1872-6860
DOI: 10.1016/j.ejor.2018.06.018
ISI #: 000442060500014
Rights: 2018 Elsevier B.V. All rights reserved.
Category: A1
Type: Journal Contribution
Validations: ecoom 2019
Appears in Collections:Research publications

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