Managing hospital visitor admission during Covid-19: A discrete-event simulation by the data of a German University Hospital

Abstract

The Corona pandemic and the associated need for visitor restrictions have defined an entirely new management task in hospitals: The hospital visitor management. The admission process of hospital visitors and the implementation of associated infection-prevention strategies such as the delivery of face masks thereby pose major challenges. In this work, we evaluate both implemented and planned admission processes in a German University Hospital based on a discrete-event simulation model and provide distinct recommendations for hospital visitor management with special consideration of digitalization, antigen testing, waiting times, space and staff utilization. We find the extraordinary potential of digitalization with a reduction of visitor waiting and service times of up to 90 percent, the significant burden for personnel and room capacity, in terms of antigen testing, especially, and the need for visitor restrictions in terms of a maximum number of visitors per inpatient.

A Simulation-Based Cost-Effectiveness Analysis of Severe Acute Respiratory Syndrome Coronavirus 2 Infection Prevention Strategies for Visitors of Healthcare Institutions

“…This is not surprising, considering recent articles on the performance of antigen tests. 24 , 25 , 26 Because of this conclusion and because of the large amount of personnel and space required, 11 testing directly before the visit seems to be at least questionable.…”

“…Hospital visitor management includes several steps such as an admission control, registration activities, or testing. 11 The regulations, thereby, are a particular burden to terminal care and critically ill patients, and especially from an ethical perspective, visitor restrictions to those groups of patients may be difficult to enforce.…”

Balanced Assignment of Patients to Healthcare Centers Using Dispatching Rules

“…Several authors have made significant contributions to the literature on patient assignments to healthcare centers. Bartenschlager et al (2022) emphasize the substantial impact of efficient assignment of patients to hospitals during the COVID-19 pandemic on reducing wait times and enhancing service. Fasshauer et al (2021) assess the challenge of patient assignment during the pandemic.…”

“…Particularly for problems involving integer programming, achieving satisfactory solutions, even for moderately sized instances, poses a formidable challenge (Teymourifar et al, 2021c). Furthermore, real-world problems are dynamic (Bartenschlager et al, 2022;Fasshauer et al, 2021;Granja et al, 2014) and often entail MOs (Doudareva and Carter, 2022;Parashar et al, 2023), which escalates the complexity of sectorization models. In pursuit of a model applicable to real-world scenarios, we employ simulation techniques (Basaglia and Spacone, 2022;Fava et al, 2022;Matthews et al, 2023;Teymourifar, 2019).…”

Assigning Patients to Healthcare Centers Using Dispatching Rules

“…Particularly for problems involving integer programming, achieving satisfactory solutions, even for moderately sized instances, poses a formidable challenge (Teymourifar et al, 2021c). Furthermore, real-world problems are dynamic (Bartenschlager et al, 2022;Fasshauer et al, 2021;Granja et al, 2014) and often entail MOs (Doudareva and Carter, 2022;Parashar et al, 2023), which escalates the complexity of sectorization models. In pursuit of a model applicable to real-world scenarios, we employ simulation techniques (Basaglia and Spacone, 2022;Fava et al, 2022;Matthews et al, 2023;Teymourifar, 2019).…”