Off-service Placement in Inpatient Ward Network: Resource Pooling versus Service Slowdown

Abstract

Inpatient ward beds play a central role in hospital operations. To better facilitate coordination of care, the beds are usually grouped into different specialized units, with each unit designated to serve patients in certain primary specialties. However, inpatient wards are often associated with high level of bed utilization and large variability in demand. When waiting time is excessively long before a bed in the primary ward becomes available, the patient may be assigned to a bed in a non-primary ward. This is referred to as off-service placement. In this paper, we take a data-driven approach to study off-service placement by taking into account three key aspects of the problem: the network structure of the wards; the complex bed assignment decisions; and the causal effect of off-service placement on patient outcome. Our analysis quantifies the trade-off between off-service placement and admission delay, and provides prescriptive solutions to improve system performance.

Keywords: Inpatient Bed Management, Off-service Placement, Network Effect, Patient Outcome, Empirical Methods, Stochastic Models