Title: Applying healthcare systems engineering methods to the patient discharge process

Authors: Jennifer A. Farris, Timothy I. Matis, Marlene McAllister, Alan Snider

Addresses: Department of Industrial Engineering, Texas Tech University, Industrial Engineering Building, Box 43061, Lubbock, TX 79409-3061, USA. ' Department of Industrial Engineering, Texas Tech University, Industrial Engineering Building, Box 43061, Lubbock, TX 79409-3061, USA. ' Medical Center Hospital, 500 West 4th St., Odessa, Texas, 79761, USA. ' Medical Center Hospital, 500 West 4th St., Odessa, Texas, 79761, USA

Abstract: The patient discharge process has been a perennial problem for hospitals of all sizes. Four decades worth of research have resulted in many insights for improving the quality of the process, but fewer breakthroughs regarding improving the speed of the process. Meanwhile, the timing of patient discharges is a key constraint on hospital capacity. Specifically, achieving better control over the discharge process may help hospitals alleviate one of their most severe capacity issues: gridlock in the emergency room. This paper presents results from a case study in a 362-bed regional teaching hospital in Texas, USA, where healthcare systems engineering methods were applied to document the current state of the discharge process and identify the most significant root causes of delays. Directions for future research on the design and management of the patient discharge process are identified and discussed, based on the case study findings and the literature review of previous work on patient discharge planning.

Keywords: healthcare engineering; patient discharges; discharge planning; patient flows; emergency rooms; gridlock; hospital admissions; admission control; capacity management; occupancy stabilisation; demand prediction; patients; scheduling; USA; United States; timing; constraints; teaching hospitals; Texas; delays; Medical Center Hospital; Odessa; collaborative enterprises; collaboration; healthcare systems; systems engineering.

DOI: 10.1504/IJCENT.2010.038355

International Journal of Collaborative Enterprise, 2010 Vol.1 No.3/4, pp.293 - 315

Published online: 01 Feb 2011 *

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