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

38 Pages Posted: 20 Apr 2017

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 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

Suggested Citation

Mills, Alex and Helm, Jonathan and Wang, Yu, Surge Capacity Deployment in Hospitals: Effectiveness of Response and Mitigation Strategies (April 20, 2017). 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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