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Increasing Throughput in Health Services Organizations. by Bruce L. Golden Decision & Information Technologies Research Day, Sept. 7, 2007. Associated Press News Item – 8/24/07. Man Dies After Surgeon Operates on Wrong Side of Head Rhode Island Hospital in Providence

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Increasing Throughput in Health Services Organizations

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Increasing throughput in health services organizations

Increasing Throughput in Health ServicesOrganizations

by

Bruce L. Golden

Decision & Information Technologies

Research Day, Sept. 7, 2007


Associated press news item 8 24 07

Associated Press News Item – 8/24/07

  • Man Dies After Surgeon Operates on Wrong Side of Head

    • Rhode Island Hospital in Providence

    • 86-year-old man dies three weeks after surgery

    • This was 3rd wrong-side surgery error in the hospital’s neurosurgery unit in 6 years

  • The hospital's public reaction

    • In the surgical team’s haste to treat the patient, it didn’t follow proper procedures

  • Hospitals need help!


Increasing throughput in health services organizations

Areas of Research Interest

  • Cardiac surgery line throughput

    • Carter Price (Ph.D. student), Ed Wasil

    • ICU vs. IMC beds

    • We used simulation

    • Increased throughput by 17%

    • Increased profit by $2.67 million/year

  • A simplified view

Home, local hospital or other location

Cardiac Surgery

ICU

IMC


Areas of research continued

Areas of Research -- continued

  • Hospital bed management

    • The ultimate goal

    • Impacts the utilization of operating rooms, surgical scheduling, admissions, referrals, the emergency department, diversions, etc.

    • Gemstone Project, 13 students, 3-year effort

    • E.g., the OR, random demand, and non-random demand

  • Reducing PACU backlog and boarding

    • Carter Price (Ph.D. student), Ed Wasil

    • Part of hospital bed management

    • Short-term goal

    • E.g., discharge by noon rather than 4 pm


Increasing throughput in health services organizations

Reducing PACU Backlog and Boarding

  • Patients flow from the PACU to intensive care beds

  • Surgeries are scheduled with surgeons in mind, without taking patient flow into account

  • Boarding occurs when a patient is forced to remain in the PACU overnight

  • Backlog and boarding increase the likelihood that surgeries will be put on hold, since patients have to remain in the OR

  • On 7/17/07, 13 patients spent the night in the PACU due to a lack of intensive care beds


Increasing throughput in health services organizations

Current Status of the PACU Project

  • An IP was formulated to balance the in-flow of scheduled surgeries with the out-flow of patients being discharged

  • Based on 6 months of recent data, the IP reduced the number of boarders by 26%

  • We are in the process of refining the model and expect to implement it within a year


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