Title: The role of operations management in improving emergency department outflow

Authors: Remco W. Rosmulder, Jan S.K. Luitse

Addresses: Department of Operations, Organization and Human Resources, School of Management and Governance, Institute for Innovation and Governance Studies, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands. ' Emergency Department, Academic Medical Centre, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands

Abstract: Worldwide, many hospitals experience problems in patient outflow from the emergency department into the clinical wards, and therefore, implement an observation unit. Literature and practical experiences, however, show that medical management in these units can be problematic. A university hospital in the Netherlands that considered implementation first analysed the problem situation using an operations management approach. For the internal medicine specialty, the steps in the patients| care delivery and the deployment of staff and resources around acute admissions were analysed. The analyses brought up many inefficiencies in the admission process and showed that nurse staffing levels in the wards did not match patient outflow from the emergency department. The results provided hospital management with more and less extensive options to address the problem situation. These were implemented first, instead of an observation unit. We encourage healthcare managers who face similar decisions to incorporate operations management aspects into their decision-making processes.

Keywords: action research; accident and emergency departments; A&E; healthcare management; hospitals; observation units; operations management; patient flow; process improvement; patient outflow; healthcare technology management; admission procedures; nurse staffing levels; medical decision making.

DOI: 10.1504/IJHTM.2011.040480

International Journal of Healthcare Technology and Management, 2011 Vol.12 No.3/4, pp.293 - 306

Published online: 28 Mar 2015 *

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