Surge Capacity deployment in Hospitals: Effectiveness of Response and Mitigation Strategies

Manufacturing & Service Operations Management, Forthcoming

Kelley School of Business Research Paper No. 17-35

33 Pages Posted: 20 Apr 2017 Last revised: 19 Jul 2019

See all articles by Alex Mills

Alex Mills

Baruch College Zicklin School of Business

Jonathan Helm

Indiana University - Kelley School of Business - Department of Operation & Decision Technologies

Yu Wang

Indiana University - Kelley School of Business - Department of Operation & Decision Technologies

Date Written: April 20, 2017

Abstract

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 individual hospitals.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. 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. 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. 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.

Keywords: Health Care Management, Service Operations, Simulation

Suggested Citation

Mills, Alex and Helm, Jonathan and Wang, Yu, Surge Capacity deployment in Hospitals: Effectiveness of Response and Mitigation Strategies (April 20, 2017). Manufacturing & Service Operations Management, Forthcoming; Kelley School of Business Research Paper No. 17-35. Available at SSRN: https://ssrn.com/abstract=2955766 or http://dx.doi.org/10.2139/ssrn.2955766

Alex Mills (Contact Author)

Baruch College Zicklin School of Business ( email )

55 Lexington Ave
New York, NY 10010
United States

Jonathan Helm

Indiana University - Kelley School of Business - Department of Operation & Decision Technologies ( email )

Business 670
1309 E. Tenth Street
Bloomington, IN 47401
United States

Yu Wang

Indiana University - Kelley School of Business - Department of Operation & Decision Technologies ( email )

Business 670
1309 E. Tenth Street
Bloomington, IN 47401
United States

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