Evaluation and implementation of a Just-In-Time bed-assignment strategy to reduce wait times for surgical inpatients

Abstract Early bed assignments of elective surgical patients can be a useful planning tool for hospital staff; they provide certainty in patient placement and allow nursing staff to prepare for patients’ arrivals to the unit. However, given the variability in the surgical schedule, they can also result in timing mismatches—beds remain empty while their assigned patients are still in surgery, while other ready-to-move patients are waiting for their beds to become available. In this study, we used data from four surgical units in a large academic medical center to build a discrete-event simulation with which we show how a Just-In-Time (JIT) bed assignment, in which ready-to-move patients are assigned to ready-beds, would decrease bed idle time and increase access to general care beds for all surgical patients. Additionally, our simulation demonstrates the potential synergistic effects of combining the JIT assignment policy with a strategy that co-locates short-stay surgical patients out of inpatient beds, increasing the bed supply. The simulation results motivated hospital leadership to implement both strategies across these four surgical inpatient units in early 2017. In the several months post-implementation, the average patient wait time decreased 25.0% overall, driven by decreases of 32.9% for ED-to-floor transfers (from 3.66 to 2.45 hours on average) and 37.4% for PACU-to-floor transfers (from 2.36 to 1.48 hours), the two major sources of admissions to the surgical floors, without adding additional capacity..

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:26

Enthalten in:

Health care management science - 26(2023), 3 vom: 09. Juni, Seite 501-515

Sprache:

Englisch

Beteiligte Personen:

Braaksma, Aleida [VerfasserIn]
Copenhaver, Martin S. [VerfasserIn]
Zenteno, Ana C. [VerfasserIn]
Ugarph, Elizabeth [VerfasserIn]
Levi, Retsef [VerfasserIn]
Daily, Bethany J. [VerfasserIn]
Orcutt, Benjamin [VerfasserIn]
Turcotte, Kathryn M. [VerfasserIn]
Dunn, Peter F. [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

BKL:

44.05$jGesundheitsökonomie

Themen:

ARIMA model
Bed assignment
Discrete-event simulation
Hospital capacity management
Hospital operations
Just-in-time
Operations management
Operations research
Patient flow

Anmerkungen:

© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

doi:

10.1007/s10729-023-09638-3

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2145442707

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