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Indiana University Bloomington

Operations & Decision Technologies

Kelley Advantage

Our Operations, Analytics and Information Systems faculty have written many of the definitive textbooks in the areas of operations, data analysis, database management, networking, and Excel modeling.

Recent Publications

Journal Articles

Design and Analysis of Hospital Admission Control for Operational Effectiveness

2011, Production and Operations Management

Jonathan E. Helm, Shervin AhmadBeygi, Mark P. Van Oyen

Abstract

Variability in hospital occupancy negatively impacts the cost and quality of patient
care delivery through increased Emergency Department (ED) congestion, emergency blockages
and diversions, elective cancelations, backlogs in ancillary services, overstaffing and understaffing.
Controlling inpatient admissions can effectively reduce variability in hospital occupancy to miti
gate these problems. Currently there are two major gateways for admission to a hospital: the ED
and scheduled elective admission. Unfortunately, in high demand hospitals, excessive wait times
make the scheduled gateway undesirable or infeasible for a subset of patients and doctors. As a
result, this group often uses the ED gateway as a means to gain admission to the hospital. To
better serve these patients and improve overall hospital functioning, we propose creating a third
gateway: an expedited patient care queue. We first characterize an optimal admission thresh
old policy using controls on the scheduled and expedited gateways for a new Markov Decision
Process model. We then present a practical policy based on insight from the analytical model
that yields reduced emergency blockages, cancelations and off-unit census via simulation based
on historical hospital data.

Citation

Helm, Jonathan E., Shervin AhmadBeygi, and Mark P. Van Oyen (2011), "Design and Analysis of Hospital Admission Control for Operational Effectiveness," Production and Operations Management, Vol. 20, No. 2, pp. 359-374.

Keywords

Health Care Operations, Patient Flow Modeling, Markov Decision Processes, Admission Control.