The emergency observation and assessment ward

A recent development to reduce ED crowding and increase urgent patient admissions is the opening of an Emergency Observation and Assessment Ward (EOA Ward). At these wards urgent patients are temporarily hospitalized until they can be transferred to an inpatient bed. In this paper we present an overflow model to evaluate the effect of employing an EOA Ward on elective and urgent patient admissions

Theoretical and Practical Aspects of Outpatient Clinic Optimization

The outpatient clinic is one of the most important departments of the hospital. Since most elective care trajectories start here, with a consultation between a care provider and a patient, the outpatient clinic functions as a gate to enter the hospital. Outpatient care is evolving rapidly around concentration of low- and high-complex care and the digitization of care processes, thus introducing new challenges in the organization of care. In this chapter we introduce the concept of access and waiting time, briefly discuss outpatient clinic capacity management, study the planning and control framework in place, and discuss Operations Research models for outpatient clinic optimization, specifically those for patient flow analysis and appointment planning. We conclude this chapter with lessons learned during the implementation of our work and discuss current challenges in outpatient clinic management. We specifically aim to support the researcher who is starting in this field, by providing a comprehensive overview of the theoretical and practical aspects of outpatient clinic optimization

Optimal allocation of MRI scan capacity among competitive hospital departments

We consider an MRI scanning facility run by a Radiology department. Several hospital departments compete for capacity and have private information regarding their demand for scans. The fairness of the capacity allocation by the Radiology department depends on the quality of the information provided by the hospital departments. We employ a generic Bayesian game approach that stimulates the disclosure of true demand (truth-telling), so that capacity can be allocated fairly. We derive conditions under which truth-telling is a Bayesian Nash equilibrium. The usefulness of the approach is illustrated with a numerical example

Increasing Surgical Productivity at Erasmus Medical Center

ERASMUS MEDICAL CENTER (EMC) is one of the largest hospitals in the Netherlands, situated in the densely populated region of Rotterdam-Rijnmond. During the first wave of the COVID-19 pandemic early 2020, EMC served as the national crisis centre from which hospital capacity in the Netherlands was centrally coordinated. As a tertiary university hospital, EMC’s Thoraxcenter is a supra-regional referral centre for cardiology and cardio-thoracic surgery. The Thoraxcenter experiences fierce competition, since eight other cardiac surgery centres are situated within an 80km radius. In order to attain economy of scale and to be able to provide the necessary regional cardiac surgical service, the EMC decided to increase the number of open heart surgeries (989 in 2015) with 150 extra in 2016, 2017 and 2018 (450 in total). After successful budget negotiations with EMC’s prevalent healthcare insurer, for 2016 a goal of 150 additional surgeries was indeed set. Here we describe how we were able to increase surgical productivity. For more detail, please see Zonderland et al (2020)

The BedGame: a classroom game based on real healthcare challenges

The BedGame is a classroom game to introduce Operations Management (OM) in healthcare, more specifically to introduce the effects of centralized versus decentralized planning, and the concepts of variability and queueing theory. In the BedGame, players assign medical and surgical specialties to nursing wards to obtain a balanced bed distribution, while fulfilling as many of the specialty-specific requirements as possible. The game was first designed to support decision making in a hospital in The Netherlands, and afterwards converted to a classroom game. The game has been successfully used in several courses at the University of Twente including “Operations Management in Health Care” (undergraduate), “Quantitative Methods for Operations Management in Health Care” (graduate), and a course on patient logistics for healthcare professionals

A Survey of Literature Reviews on Patient Planning and Scheduling in Healthcare

This chapter provides a classification of literature reviews on patient planning and scheduling decisions in healthcare. To this end, we provide a mathematical interpretation of hierarchical planning levels and then add the planning complexity dimension to an existing planning and scheduling framework, resulting in a 3D framework for patient planning and scheduling decisions in healthcare. Subsequently, we provide an overview on recent surveys and reviews on this topic and position these studies in the 3D framework