Surge Capacity Deployment in Hospitals: Effectiveness of Response and Mitigation Strategies
2020; Institute for Operations Research and the Management Sciences; Linguagem: Inglês
10.1287/msom.2019.0838
ISSN1526-5498
AutoresAlex F. Mills, Jonathan E. Helm, Yu Wang,
Tópico(s)Healthcare Operations and Scheduling Optimization
ResumoAboutSectionsView PDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked InEmail Go to Section HomeManufacturing & Service Operations ManagementVol. 23, No. 2 Surge Capacity Deployment in Hospitals: Effectiveness of Response and Mitigation StrategiesAlex F. Mills , Jonathan E. Helm , Yu WangAlex F. Mills , Jonathan E. Helm , Yu WangPublished Online:30 Mar 2020https://doi.org/10.1287/msom.2019.0838AbstractProblem definition: Major hospitals frequently lack adequate space to accommodate emergency patients. Managers can take actions to create surge capacity, an immediate additional supply of medical services to accommodate increased demand. We study operational strategies that improve surge capacity, and we identify how they can be most effectively deployed based on the characteristics of individual hospitals. Academic/practical relevance: Recent government regulations in the United States have increased pressure on hospitals to improve emergency preparedness. Specifically, hospitals must be able to show that they have taken adequate measures to manage surge capacity. Methodology: We formulate an optimization model of early disposition actions that can be used to create surge capacity in a hospital. We analyze the model to understand its structural properties and compare two strategies to improve surge capacity: coordinated early discharge, which occurs during the response, and inpatient workload smoothing, which can help mitigate the need for response actions. Results: We show analytically that without coordination, hospitals always act too conservatively in discharging patients to accommodate surge arrivals and that smoothing the elective inpatient workload reduces the expected cost of surge response. In the numerical study, we find a utilization sweet spot in which smoothing is best at increasing surge capacity, and we show coordination increases the number of surges and number of early discharges, while smoothing mitigates these effects, making surges less frequent and less costly. Managerial implications: Coordination is effective at increasing surge capacity for all types of hospitals, but when considering the holistic impact to the hospital, coordination and workload smoothing are often complementary strategies for improving surge response. Moreover, hospitals with sufficiently many electives and moderately high utilization should prioritize mitigation efforts when planning for emergencies. Previous Back to Top Next FiguresReferencesRelatedInformationCited byResource planning strategies for healthcare systems during a pandemicEuropean Journal of Operational Research, Vol. 304, No. 1Surgical Case-Mix and Discharge Decisions: Does Within-Hospital Coordination Matter?Hessam Bavafa, Lerzan Örmeci, Sergei Savin, Vanitha Virudachalam9 December 2021 | Operations Research, Vol. 70, No. 2Variation of Daily Care Demand in Swiss General Hospitals: Longitudinal Study on Capacity Utilization, Patient Turnover and Clinical Complexity Levels19 August 2021 | Journal of Medical Internet Research, Vol. 23, No. 8 Volume 23, Issue 2March–April 2021Pages 267-545, C2 Article Information Supplemental Materials Metrics Information Received:April 19, 2017Accepted:June 13, 2019Published Online:March 30, 2020 Copyright © 2020, INFORMSCite asAlex F. Mills, Jonathan E. Helm, Yu Wang (2020) Surge Capacity Deployment in Hospitals: Effectiveness of Response and Mitigation Strategies. Manufacturing & Service Operations Management 23(2):367-387. https://doi.org/10.1287/msom.2019.0838 Keywordsemergency responsesurge capacityworkload smoothingemergency department and inpatient coordinationPDF download
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