Hospital admission planning to optimize major resources utilization under uncertainty

N.P. Dellaert, J. Jeunet

Research output: Book/ReportReportAcademic

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Abstract

Admission policies for elective inpatient services mainly result in the management of a single resource: the operating theatre as it is commonly considered as the most critical and expensive resource in a hospital. However, other bottleneck resources may lead to surgery cancellations, such as bed capacity and nursing staff in Intensive Care (IC) units and bed occupancy in wards or medium care (MC) services. Our incentive is therefore to determine a master schedule of a given number of patients that are divided in several homogeneous categories in terms of the utilization of each resource: operating theatre, IC beds, IC nursing hours and MC beds. The objective is to minimize the weighted deviations of the resource use from their targets and probabilistic lengths of stay in each unit (IC and MC) are considered. We use a Mixed Integer Program model to determine the best admission policy. The resulting admission policy is a tactical plan, as it is based upon an average number of patients with average characteristics. For the operational schedule we consider several options to create feasibility: slack planning, updating the tactical plan on the basis of actual arrivals of patients and flexibility in patient group. Our incentive in this paper is to determine which combination of slack planning, updating frequency and patient flexibility leads to the best results in terms of waiting times for patients, target deviations and plan changes for the operating specialists.
Original languageEnglish
Place of PublicationEindhoven
PublisherTechnische Universiteit Eindhoven
ISBN (Print)978-90-386-2327-6
Publication statusPublished - 2010

Publication series

NameBETA publicatie : working papers
Volume319
ISSN (Print)1386-9213

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