Hospital Systems Occupancy Prediction and Control to Increase Access, Smooth Provider Workload, and Reduce Cost

该研究项目创建了一种基于企业范围内的患者流模型的创新方法，以指导操作入院和调度实践，以顺利进行医院普查/入住率。我们的研究将提供理论基础和实用的决策支持方法，包括：(1)非计划/紧急患者到达的随机性，(2)计划的选择性外科和内科住院患者，(3)床位块和床位单位/病房占用的随机系统动力学，(4)患者通过床位单位的治疗轨迹，以及(5)其他关键医院资源（即医生，护士，设备，专科床位，手术时间等）。将建立分析模型，将医院病床近似为动态控制的排队网络。一个理论的病人流建模方法将被用来捕捉病人病床资源需求的随机演变，从而进行人口普查。新的优化/控制模型将为(1)选修入学计划和(2)人口普查资源/控制提供方法。医院往往缺乏从系统角度开发的严格、准确的企业级规划和日常普查管理工具。本研究将为一种新颖的在线决策支持方法提供理论基础、实践方法和概念证明，通过减少周转和访问延迟，更好地将护理工作量与预定人员匹配，以提高患者护理质量，并降低医院运营成本，从而实现增加访问。这项研究吸引了在创新方面被公认为领导者的合作医院。结果将通过出版物传播到工程和公共卫生界，目标是高度可见的工程和医学/卫生保健期刊。工程、商业和公共卫生专业的研究生和本科生将通过课堂教学（包括教学工具）和参与研究而受益。高度相关的应用程序将使学生成为改善医院运作的变革推动者。

This research project creates an innovative methodology based upon enterprise-wide patient flow modeling to guide operational admission and scheduling practices to smooth hospital census/occupancy. Our research will provide theoretical foundations as well as a practical decision support methodology incorporating (1) the stochasticity of unscheduled/emergent patient arrivals, (2) scheduled elective surgical and medical inpatients, (3) the stochastic system dynamics of bed block and occupancy by bed unit/ward and (4) the patient's treatment trajectory through the bed units and (5) other critical hospital resources (i.e. physicians, nurses, equipment, specialized beds, operating time etc.). Analytical models will be developed to approximate the hospital beds as a dynamically controlled queueing network. A theoretical patient flow modeling methodology will be used to capture the stochastic evolution of the patient's bed resource needs and thereby census. New optimization/control models will provide methods for (1) elective admission planning and (2) census recourse/control. Hospitals frequently lack rigorous, accurate enterprise level planning and daily census management tools developed from a systems perspective. This research will provide the theoretical foundations, practical methodologies, and proof of concept for a novel online decision support approach to achieve increased access by reducing turnaways and delays to access, better matching of the care workload to the scheduled staff for improved quality of patient care, and reduced hospital operating costs. This research engages partner hospitals that are recognized as leaders in innovation. Outcomes will be disseminated to engineering and public health communities through publications targeting highly visible journals in engineering, and medicine/healthcare. Graduate and undergraduate students in engineering, business, and public health will benefit through classroom instruction (including teaching tools) and involvement in the research. The highly relevant application will equip students to be change agents in improving hospital operations.