An Overview of Hospital Capacity Planning and Optimisation

Humphreys, Peter; Spratt, Belinda; Tariverdi, Mersedeh; Burdett, Robert L.; Cook, David; Yarlagadda, Prasad K.D.V.; Corry, Paul

doi:10.3390/healthcare10050826

Cited by 9 publications

(5 citation statements)

References 118 publications

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“…This intervention highlights the creation of beds with the optimization of operational procedures. Further financial impact can be implied from the potential cost savings needed to create more physical space, as well as the revenue that is generated with the creation of the available beds [24].…”

Section: Discussionmentioning

confidence: 99%

The Utilization of 15-Minute Multidisciplinary Rounds to Reduce Length of Stay in Patients under Observation Status

Patel,

Alshami,

Douedi

et al. 2023

Healthcare

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With the recent change to value-based care, institutions have struggled with the appropriate management of patients under observation. Observation status can have a huge impact on hospital and patient expenses. Institutions have implemented specialized observation units to provide better care for these patients. Starting in January 2020, coinciding with the initiation of daily multidisciplinary rounds, our study focused on patients aged 18 and older admitted to our hospital under observation status. Efforts were built upon prior initiatives at Jersey Shore University Medical Center (JSUMC) to optimize patient care and length of stay (LOS) reduction. The central intervention revolved around the establishment of daily “Observation Huddles”—succinct rounds led by hospital leaders to harmonize care for patients under observation. The primary aim was to assess the impact of daily multidisciplinary rounds (MDR) on LOS, while our secondary aim involved identifying specific barriers and interventions that contributed to the observed reduction. Our study revealed a 9-h reduction in observation time, resulting in approximately USD 187.50 saved per patient. When accounting for the period spanning 2020 to 2022, potential savings totaled USD 828,187.50 in 2020, USD 1,046,062.50 in 2021, and USD 1,243,562.50 in 2022. MDR for observation patients led to a reduction in LOS from 29 h to 20 h (p < 0.001).

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Section: Discussionmentioning

confidence: 99%

The Utilization of 15-Minute Multidisciplinary Rounds to Reduce Length of Stay in Patients under Observation Status

Patel,

Alshami,

Douedi

et al. 2023

Healthcare

View full text Add to dashboard Cite

show abstract

“…This can involve processes within the hospital (internal processes) as well as beyond the walls of the hospital (external processes). Furthermore, less unnecessary or undesirable inflow of patients will reduce the workload of the system (see, e.g., [ 36 , 37 ]). Finally, expanding or making smarter use of the available capacity also has a direct positive impact on the workload (see, e.g., [ 38 , 39 ]).…”

Section: The Existing Literaturementioning

confidence: 99%

The Inflow, Throughput and Outflow of COVID-19 Patients in Dutch Hospitals: Experiences from Experts and Middle Managers

Okkerman,

Moeke,

Janssen

et al. 2023

Healthcare

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At the beginning of 2020, the large and unforeseen inflow of COVID-19 patients had a deep impact on the healthcare operations of Dutch hospitals. From a patient flow logistics perspective, each hospital handled the situation largely in its own particular and improvised way. Nevertheless, some hospitals appeared to be more effective in their dealing with this sudden demand for extra care than others. This prompted a study into the factors which hindered and facilitated effective operations during this period. We provide an overview of actions and measures for organizing and managing the inflow, throughput and outflow of COVID-19 patients within Dutch hospitals from various types of departments in a large number of hospitals in The Netherlands, based on interviews with nine experts and twelve hospital managers. Ten actions or measures have been identified, which have been divided into the following three dimensions: Streamlining of the underlying in- and external processes, reducing unnecessary or undesirable inflow of patients and increasing or making more adequate use of the available (human) capacity. The main lessons learned are the importance of integral tuning in the care process, giving up habits and self-interest, good information provision and the middle manager as a linking pin.

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“…Hospital capacity planning [ 3 ], an essential component of healthcare management requires accurate statistical models of LOS. Recent events such as the Covid-19 pandemic have further highlighted the importance of this fact [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Even though LOS models based on DRGs have received significant attention due to their utility in clinical decision-making (as discussed in Section Scale of modeling, recent developments have called for “geekier” models for capacity requirements [ 7 ]. These models see the hospital as an interdependent system [ 3 ], further underscoring the May 24, 2023 2/28 significance of choosing the correct random variable for LOS modeling in capacity planning. As suggested in [ 8 ], although DRGs are useful for pricing calculations, they offer limited guidance on the mix of resources needed.…”

Section: Introductionmentioning

confidence: 99%

Hospital length of stay: A cross-specialty analysis and Beta-geometric model

et al. 2023

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Background The typical hospital Length of Stay (LOS) distribution is known to be right-skewed, to vary considerably across Diagnosis Related Groups (DRGs), and to contain markedly high values, in significant proportions. These very long stays are often considered outliers, and thin-tailed statistical distributions are assumed. However, resource consumption and planning occur at the level of medical specialty departments covering multiple DRGs, and when considered at this decision-making scale, extreme LOS values represent a significant component of the distribution of LOS (the right tail) that determines many of its statistical properties. Objective To build actionable statistical models of LOS for resource planning at the level of healthcare units. Methods Through a study of 46, 364 electronic health records over four medical specialty departments (Pediatrics, Obstetrics/Gynecology, Surgery, and Rehabilitation Medicine) in the largest hospital in Thailand (Siriraj Hospital in Bangkok), we show that the distribution of LOS exhibits a tail behavior that is consistent with a subexponential distribution. We analyze some empirical properties of such a distribution that are of relevance to cost and resource planning, notably the concentration of resource consumption among a minority of admissions/patients, an increasing residual LOS, where the longer a patient has been admitted, the longer they would be expected to remain admitted, and a slow convergence of the Law of Large Numbers, making empirical estimates of moments (e.g. mean, variance) unreliable. Results We propose a novel Beta-Geometric model that shows a good fit with observed data and reproduces these empirical properties of LOS. Finally, we use our findings to make practical recommendations regarding the pricing and management of LOS.

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An Overview of Hospital Capacity Planning and Optimisation

Cited by 9 publications

References 118 publications

The Utilization of 15-Minute Multidisciplinary Rounds to Reduce Length of Stay in Patients under Observation Status

The Utilization of 15-Minute Multidisciplinary Rounds to Reduce Length of Stay in Patients under Observation Status

The Inflow, Throughput and Outflow of COVID-19 Patients in Dutch Hospitals: Experiences from Experts and Middle Managers

Hospital length of stay: A cross-specialty analysis and Beta-geometric model

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