Surge Capacity Deployment in Hospitals: Effectiveness of Response and Mitigation Strategies
38 Pages Posted: 20 Apr 2017
Date Written: April 20, 2017
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 deployed most effectively based on the characteristics of a hospital. 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 be able to provide surge capacity. 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. Coordinated discharge and inpatient workload smoothing are effective ways to improve surge response, but the relative benefit of each strategy depends on factors including hospital size, utilization, patient mix, and average inpatient length-of-stay. Hospitals that are smaller, less heavily utilized, or have longer inpatient length-of-stay, benefit more from coordinated discharge. Hospitals that are larger, more heavily utilized, or have shorter inpatient length-of-stay, benefit more from inpatient workload smoothing. Despite the organizational distance between elective inpatient services and the emergency department, inpatient demand management practices have a clear effect on emergency response. Large, heavily-utilized hospitals, such as those in urban areas, should prioritize mitigation efforts when planning for emergencies.
Keywords: Health Care Management, Service Operations, Simulation
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