ORAHS2024
Abstract Submission

289. Post-triage patient reallocation in emergency department networks

Contributed abstract in session TD-3: Patient flow, stream Regular talks.

Tuesday, 16:00-17:30
Room: Room S2

Authors (first author is the speaker)

1. Dario Nicola Marchese
Management, Information and Production Engineering, University of Bergamo
2. Mattia Cattaneo
Department of Management, Information and Production Engineering, University of Bergamo
3. Sebastian Birolini
Department of Management, Information, and Production Engineering, University of Bergamo

Abstract

Over the past few decades, the timely provision of emergency care has emerged as a significant challenge due to a consistent rise in the number of visits to emergency departments each year, especially non-urgent. This increase is not matched by a corresponding expansion in hospital resources and infrastructure, resulting in a high level of overcrowding.
In this work, we aim to contribute to the issue of ED de-congestion particularly focusing on the reduction of waiting times by proposing a reallocation scheme for non-urgent patients that leverages inter-temporal demand-supply imbalances across EDs within the same multi-hospital network.
To implement this approach, we derive that reallocation is beneficial when there is imbalance between EDs congestion under steady-state conditions, albeit determining the optimal rate of reallocation poses significant challenges. For this reason, we develop a two-stage multi-objective optimization model for ED processes and planning, where arriving patients can be either admitted or diverted to another hospital according to system capacity and congestion, and subject to consistent vehicle routing and availability. This model is applied in a real-case study involving a multi-hospital system comprising four hospitals in northern Italy, within which a bound of the reallocation benefits is constructed to validate the robustness of the proposed approach.

Keywords

Status: accepted

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