A Queueing Model to Evaluate the Impact of Patient 'Batching' on Throughput and Flow Time in a Medical Teaching Facility

Posted: 30 May 2012

See all articles by Gregory Dobson

Gregory Dobson

University of Rochester - Simon Business School

Hsiao-Hui Lee

National Chengchi University (NCCU) - Department of Management Information Systems

Arvind Sainathan

University of Rochester - Simon Business School

Vera Tilson

University of Rochester - Simon Business School

Date Written: April 13, 2012

Abstract

We consider the work flow in a medical teaching facility, examining the process that involves an initial patient exam by a resident physician, a subsequent conference between the resident and the attending physician, and the attending physician’s visit with the patient. We create an analytical model of a tandem queue with finite buffer space, to analyze the impact of different work prioritization policies on the throughput and the flow time of patients in the facility — measures that influence both the facility’s finances and patients’ satisfaction. We derive throughput-optimal policies and show that these policies involve dynamic batching. This finding is interesting because our model does not include any setup times, and setup times normally imply batching; rather it is the uncertain service times and the requirement for simultaneous service in the conference step that make batching optimal. The optimal dynamic batching policy is complex, so we consider a simpler static batching policy. We show that, in systems with limited buffer space, large batches can sometimes degrade efficiency by simultaneously increasing flow time and decreasing throughput. However, in general, both flow time and throughput increase with batch size. Flow time increases at a faster rate than throughput, so hospital management may want to consider what batch size is optimal given the value it places on the two measures.

Keywords: tandem queues, concurrent service, finite buffer, batching, flow time vs. throughput, Health Care Management, Queueing Theory, Service Operations, Dynamic Programming

Suggested Citation

Dobson, Gregory and Lee, Hsiao-Hui and Sainathan, Arvind and Tilson, Vera, A Queueing Model to Evaluate the Impact of Patient 'Batching' on Throughput and Flow Time in a Medical Teaching Facility (April 13, 2012). Simon School Working Paper No. FR 12-01. Available at SSRN: https://ssrn.com/abstract=2070880

Gregory Dobson (Contact Author)

University of Rochester - Simon Business School ( email )

Carol Simon Hall 3-310
Rochester, NY 14627
United States
585-275-2670 (Phone)
585-442-6652 (Fax)

Hsiao-Hui Lee

National Chengchi University (NCCU) - Department of Management Information Systems ( email )

No. 64, Section 2, Zhǐnán Rd
Wenshan District
Taipei City
Taiwan

Arvind Sainathan

University of Rochester - Simon Business School ( email )

Rochester, NY 14627
United States

Vera Tilson

University of Rochester - Simon Business School ( email )

Rochester, NY 14627
United States

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