Bringing Robustness to Patient Flow Management Through Optimized Patient Transports in Hospitals

Abstract

Intra-hospital transports are often required for diagnostic or therapeutic reasons. Depending on the hospital layout, transportation between nursing wards and service units is either provided by ambulances or by trained personnel who accompany patients on foot. In many large German hospitals, the patient transport service is poorly managed and lacks workflow coordination. This contributes to higher hospital costs (e.g. when a patient is not delivered to the operating room on time) and to patient inconvenience due to longer waiting times. We have designed a computer-based planning systemOpti-TRANS c -that supports all phases of the transportation flow, ranging from travel booking, dispatching transport requests to monitoring and reporting trips in real-time.The methodology developed to solve the underlying optimization problem -a dynamic dial-a-ride problem with hospital-specific constraints -draws on fast heuristic methods to * Corresponding author.1 ensure the efficient and timely provision of transports. We illustrate the strong impact of Opti-TRANS c on the daily performance of the patient transportation service of a large German hospital. The major benefits obtained with the new tool include streamlined transportation processes and workflow, significant savings and improved patient satisfaction. Moreover, the new planning system has contributed to increase awareness among hospital staff about the importance of implementing efficient logistics practices.Medical diagnostic facilities and treatment units are among the most daily visited departments of a hospital, both by inpatients and outpatients. In particular, inpatients with limited mobility are accompanied by trained staff from and to these service areas. If intra-hospital movement is required between health care units within the same building then patients are pushed on gurneys, beds or wheelchairs. In campus-based hospitals, inter-building transportation is provided by appropriate vehicles, mostly ambulances, which can be shared by several patients.The organization and provision of intra-hospital transportation for patients, as well as for supplies and equipment, are among the daily logistics activities conducted in a hospital. Although these ancillary services seem simple and straightforward, they impact significantly on the quality of health care and on hospital costs. For example, the late delivery of a patient to a high cost service facility, such as an operating theater or a magnetic resonance imaging department, leads to the underutilization of valuable (staff and equipment) resources. In addition, it disrupts the initially planned schedules of these units. On the other hand, missing an appointment often results in extended waiting time for the patient or even in rescheduling the appointment, thus impacting negatively on patient satisfaction.Despite its importance, the role played by logistics is often overlooked by health care organizations. A recent study by Landry and Philippe (2004) has revealed that logistics related activities account...

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