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Increasing Throughput in Health Services Organizations

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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  1. Increasing Throughput in Health ServicesOrganizations by Bruce L. Golden Decision & Information Technologies Research Day, Sept. 7, 2007

  2. 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!

  3. 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

  4. 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

  5. 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

  6. 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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