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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
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!
slide3

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
slide5

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
slide6

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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