Blocking in Healthcare Operations: A New Heuristic and an Application
Blocking in Healthcare Operations: A New Heuristic and an Application
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DOI：
10.1111/j.1937-5956.2011.01230.x
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发表时间：
2011-05-01
影响因子：
5
通讯作者：
Coe, Edwin
中科院分区：
文献类型：
--
作者：
Bretthauer, Kurt M.;Heese, H. Sebastian;Coe, Edwin
我们考虑医院环境中最优容量分配的问题，其中患者经过一组单元，例如重症监护和急症护理（AC），或急症护理和急症后护理。如果第二阶段已满，则在第一阶段完成服务的患者将被阻塞，不能离开第一阶段。我们为串联系统开发了一种新的启发式方法，以有效地评估这种阻塞对系统性能的影响，并且我们证明，与精确解和文献中提出的其他方法相比，这种启发式方法表现良好。此外，我们还展示了如何将串联启发式方法用作构建块，对具有任意患者路径的更复杂的多阶段医院系统进行建模，并为单元之间发生此类阻塞的真实医院系统获得见解和可操作的容量策略。
We consider the problem of optimal capacity allocation in a hospital setting, where patients pass through a set of units, for example intensive care and acute care (AC), or AC and post-acute care. If the second stage is full, a patient whose service at the first stage is complete is blocked and cannot leave the first stage. We develop a new heuristic for tandem systems to efficiently evaluate the effects of such blocking on system performance and we demonstrate that this heuristic performs well when compared with exact solutions and other approaches presented in the literature. In addition, we show how our tandem heuristic can be used as a building block to model more complex multi-stage hospital systems with arbitrary patient routing, and we derive insights and actionable capacity strategies for a real hospital system where such blocking occurs between units.