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Article: A model of ICU bumping

TitleA model of ICU bumping
Authors
Issue Date2010
PublisherI N F O R M S. The Journal's web site is located at http://or.pubs.informs.org
Citation
Operations Research, 2010, v. 58 n. 6, p. 1564-1576 How to Cite?
AbstractMany intensive care units (ICUs) face overcrowding. One response to this overcrowding is to bump ICU patients to other departments of the hospital to make room for new patient arrivals. Such bumping clearly has the potential to reduce quality of care. In this paper we develop a stochastic model of a single ICU with patient bumping. The purpose of this model is to enable planners to predict performance, in terms of bumping, under differing arrival patterns and capacity. We develop a Markov chain model and a new aggregation-disaggregation algorithm for this problem that enables us to keep track of the time in system for each patient despite the high dimensionality of the problem. Our approach allows for more accurate modeling of the system than previous work that assumed an exponential distribution for length of stay (LOS). We also demonstrate the superior computational efficiency of our approach over the Gauss-Seidel iterative method for solving the Markov chain. Finally, we use the model to explore how different surgery schedules influence bumping rates. © 2010 INFORMS.
Persistent Identifierhttp://hdl.handle.net/10722/164748
ISSN
2015 Impact Factor: 1.777
2015 SCImago Journal Rankings: 3.528
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorDobson, Gen_HK
dc.contributor.authorLee, HHen_HK
dc.contributor.authorPinker, Een_HK
dc.date.accessioned2012-09-20T08:09:03Z-
dc.date.available2012-09-20T08:09:03Z-
dc.date.issued2010en_HK
dc.identifier.citationOperations Research, 2010, v. 58 n. 6, p. 1564-1576en_HK
dc.identifier.issn0030-364Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/164748-
dc.description.abstractMany intensive care units (ICUs) face overcrowding. One response to this overcrowding is to bump ICU patients to other departments of the hospital to make room for new patient arrivals. Such bumping clearly has the potential to reduce quality of care. In this paper we develop a stochastic model of a single ICU with patient bumping. The purpose of this model is to enable planners to predict performance, in terms of bumping, under differing arrival patterns and capacity. We develop a Markov chain model and a new aggregation-disaggregation algorithm for this problem that enables us to keep track of the time in system for each patient despite the high dimensionality of the problem. Our approach allows for more accurate modeling of the system than previous work that assumed an exponential distribution for length of stay (LOS). We also demonstrate the superior computational efficiency of our approach over the Gauss-Seidel iterative method for solving the Markov chain. Finally, we use the model to explore how different surgery schedules influence bumping rates. © 2010 INFORMS.en_HK
dc.languageengen_US
dc.publisherI N F O R M S. The Journal's web site is located at http://or.pubs.informs.orgen_HK
dc.relation.ispartofOperations Researchen_HK
dc.titleA model of ICU bumpingen_HK
dc.typeArticleen_HK
dc.identifier.emailLee, HH: hhlee@hku.hken_HK
dc.identifier.authorityLee, HH=rp01556en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1287/opre.1100.0861en_HK
dc.identifier.scopuseid_2-s2.0-78651415510en_HK
dc.identifier.hkuros208346en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-78651415510&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume58en_HK
dc.identifier.issue6en_HK
dc.identifier.spage1564en_HK
dc.identifier.epage1576en_HK
dc.identifier.eissn1526-5463-
dc.identifier.isiWOS:000285746300003-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridDobson, G=7005490648en_HK
dc.identifier.scopusauthoridLee, HH=35757543400en_HK
dc.identifier.scopusauthoridPinker, E=6603181996en_HK

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