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Flexible Resource Utilization in Healthcare

Ferrand, Yann B.
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1337289368

Abstract Details

2012, PhD, University of Cincinnati, Business: Business Administration.
This dissertation investigates issues of capacity utilization in two specific healthcare settings, the operating room (OR), and the emergency department (ED). Common to both settings, resources are scarce and the patients seeking services are of different priority levels. These characteristics, also found in various other environments, translate into specific difficulties in managing the utilization of healthcare resources effectively. In the OR setting, a key challenge lies in balancing the goals of efficiency and responsiveness, which are conflicting. In the ED setting, a recurrent operational challenge is to manage timely care given multiple priority classes of patients. In both environments, to address these challenges, resources can be organized in different ways. On the one hand, resources could be designed to be flexible, so that any resource can provide service to any type of patient, and on the other hand, resources could be dedicated to a particular group of patients, and focus on providing service to those patients. In either environment, having flexible resources is beneficial for high-priority patients, but detrimental to low-priority patients. Meanwhile, dedicated resources for different groups of patients can help low-priority patients, but induces potential for greater capacity imbalances since it limits patients' access to resources. We aim to reconcile this trade-off between efficiency and responsiveness in the OR setting and in the ED environment by investigating novel ways to manage flexible resources in these two environments, based on the concept of partial flexibility. We study potential benefits of these approaches and provide insights to help managers implement partial flexibility in practice. We take an operations management approach, ground our research questions in interactions with hospital administrators and medical doctors, and use discrete event simulation modeling as a methodology to develop models that would accurately represent the systems under investigation, and factor in the stochastic nature of patient arrival events and processing time variability, based on hospital data. In the OR setting, the main result is that partial flexibility, whether it be with a few flexible rooms or a few dedicated rooms, outperforms both a policy of complete flexibility and a policy of complete dedication. The implication for hospital managers is that they can better handle the trade-off between responsiveness and efficiency by deploying one of these two forms of partial flexibility. In the ED environment, our main findings on resource dedication are that strict dedication and partial dedication without any process improvement do not achieve the objective of reducing average flow time of low-priority patients without increasing average flow time of high-priority patients. Dynamic prioritization can provide a Pareto improvement in the performance of the system, reducing wait time for the lowest priority patients significantly without increasing the wait time for the higher priority patients.
Michael Magazine, PhD (Committee Chair)
Uday Rao, PhD (Committee Chair)
Craig Froehle, PhD (Committee Member)
Hongdao Huang, PhD (Committee Member)
175 p.
Resource allocation; Partial flexibility; Simulation; Operating room; Emergency department; ;

Recommended Citations

Citations

  • Ferrand, Y. B. (2012). Flexible Resource Utilization in Healthcare [Doctoral dissertation, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1337289368

    APA Style (7th edition)

  • Ferrand, Yann. Flexible Resource Utilization in Healthcare. 2012. University of Cincinnati, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1337289368.

    MLA Style (8th edition)

  • Ferrand, Yann. "Flexible Resource Utilization in Healthcare." Doctoral dissertation, University of Cincinnati, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1337289368

    Chicago Manual of Style (17th edition)

ucin1337289368
1,916
© 2012, all rights reserved.
This open access ETD is published by University of Cincinnati and OhioLINK.
Release 3.2.12