From birth to
death, we are all part of the healthcare system; we rely on hospitals, doctors,
nurses etc to provide preventive care and to treat our illnesses. Healthcare is
perhaps one of the most important indicators of quality of life and longevity
in a society.
However healthcare
consumes an increasing percentage of our economic product. This rising cost can
be attributed in part to the increase of life expectancy and to the expense of new treatments, but also it can be attributed to inefficiencies
in healthcare delivery.
Patient flow
represents one of the most challenging aspects of the healthcare system. When
the system works well, patients flow at a steady path, moving efficiently
through the stages of care, and every stage is completed with minimal delay, however,
when the system is broken, patients
accumulate meaning the patients suffer considerable queuing delays.
Healthcare has
unique features that make queueing problems particularly difficult to solve:
- Queues
create additional work for clinicians. Patients must be
monitored and served while waiting, and their conditions can deteriorate,
necessitating additional work once they get to be treated. Thus, as queues
become large, the workload increases and the capacity to serve patients deteriorate.
- It can be difficult to distinguish
productive waiting from unproductive waiting. In a traditional
queueing system the most desirable outcome is instantaneous service, however, in
a hospital, it is undesirable to reduce the length of stay to zero, as patients
need to be monitored and cared during recovery periods. This can result in conflicting
objectives in managing hospital beds when trying to separate productive waiting
(recovery) from unproductive waiting (waiting for tests).
At hospitals, care
is provided through many specialized departments, therefore when a patient
arrives at the emergency department encounters repeated waits as he or she
progresses from stage to stage, waiting for rooms, equipment, physicians,
nurses, technicians, beds, records, gurneys and so forth. When the system
becomes overloaded, the patient may wait hours or even days from being seen in
the emergency department until being given the ok.
We can summarize
the three major causes of queues in hospitals:
- Idle capacity due to a failure
to synchronize resources (ensuring that technicians, nurses, physicians,
patients, etc are present at the same time).
- Inadequate communication to ensure the relevant departments are prepared to receive patients from other areas.
- Inefficient processes that require more work than necessary or un-needed
repetition of work.
Some reasons that will lead to patients waiting for
placement in a hospital are can be other patients waiting too long to complete
the discharge process, beds remaining idle too long from when a patient departs
until the bed is prepared for the next patient, poor communication between the
emergency department and the ward, a shortage of technicians, or even because
there is an inadequate number of gurneys to transport patients etc.
Working on improving patient flow at hospitals will
not only save money but also will save lives.
