Patient Flow: Reducing Delay in Healthcare Delivery (International Series in Operations Research & Management Science Book 206)

"This book is dedicated to improving healthcare through reducing delays experienced by patients. With an interdisciplinary approach, this new edition, divided into five sections, begins by examining healthcare as an integrated system. Chapter 1 provides a hierarchical model of healthcare, rising from departments, to centers, regions and the "macro system." A new chapter demonstrates how to use simulation to assess the interaction of system components to achieve performance goals, and Chapter 3 provides hands-on methods for developing process models to identify and remove bottlenecks, and for developing facility plans. Section 2 addresses crowding and the consequences of delay. Two new chapters (4 and 5) focus on delays in emergency departments, and Chapter 6 then examines medical outcomes that result from waits for surgeries. Section 3 concentrates on management of demand. Chapter 7 presents breakthrough strategies that use real-time monitoring systems for continuous improvement. Chapter 8 looks at the patient appointment system, particularly through the approach of advanced access. Chapter 9 concentrates on managing waiting lists for surgeries, and Chapter 10 examines triage outside of emergency departments, with a focus on allied health programs Section 4 offers analytical tools and models to support analysis of patient flows. Chapter 11 offers techniques for scheduling staff to match patterns in patient demand. Chapter 12 surveys the literature on simulation modeling, which is widely used for both healthcare design and process improvement. Chapter 13 is new and demonstrates the use of process mapping to represent a complex regional trauma system. Chapter 14 provides methods for forecasting demand for healthcare on a region-wide basis. Chapter 15 presents queueing theory as a method for modeling waits in healthcare, and Chapter 16 focuses on rapid delivery of medication in the event of a catastrophic event. Section 5 focuses on achieving change. Chapter 17 provides a diagnostic for assessing the state of a hospital and using the state assessment to select improvement strategies. Chapter 18 demonstrates the importance of optimizing care as patients transition from one care setting to the next. Chapter 19 is new and shows how to implement programs that improve patient satisfaction while also improving flow. Chapter 20 illustrates how to evaluate the overall portfolio of patient diagnostic groups to guide system changes, and Chapter 21 provides project management tools to guide the execution of patient flow projects."--Library of Congress This book is dedicated to improving healthcare through reducing delays experienced by patients. With an interdisciplinary approach, this new edition, divided into five sections, begins by examining healthcare as an integrated system. Chapter 1 provides a hierarchical model of healthcare, rising from departments, to centers, regions and the 3zBmacro system. 3yB A new chapter demonstrates how to use simulation to assess the interaction of system components to achieve performance goals, and Chapter 3 provides hands-on methods for developing process models to identify and remove bottlenecks, and for developing facility plans. Section 2 addresses crowding and the consequences of delay. Two new chapters (4 and 5) focus on delays in emergency departments, and Chapter 6 then examines medical outcomes that result from waits for surgeries. Section 3 concentrates on management of demand. Chapter 7 presents breakthrough strategies that use real-time monitoring systems for continuous improvement. Chapter 8 looks at the patient appointment system, particularly through the approach of advanced access. Chapter 9 concentrates on managing waiting lists for surgeries, and Chapter 10 examines triage outside of emergency departments, with a focus on allied health programs Section 4 offers analytical tools and models to support analysis of patient flows. Chapter 11 offers techniques for scheduling staff to match patterns in patient demand. Chapter 12 surveys the literature on simulation modeling, which is widely used for both healthcare design and process improvement. Chapter 13 is new and demonstrates the use of process mapping to represent a complex regional trauma system. Chapter 14 provides methods for forecasting demand for healthcare on a region-wide basis. Chapter 15 presents queueing theory as a method for modeling waits in healthcare, and Chapter 16 focuses on rapid delivery of medication in the event of a catastrophic event. Section 5 focuses on achieving change. Chapter 17 provides a diagnostic for assessing the state of a hospital and using the state assessment to select improvement strategies. Chapter 18 demonstrates the importance of optimizing care as patients transition from one care setting to the next. Chapter 19 is new and shows how to implement programs that improve patient satisfaction while also improving flow. Chapter 20 illustrates how to evaluate the overall portfolio of patient diagnostic groups to guide system changes, and Chapter 21 provides project management tools to guide the execution of patient flow projects Front Matter....Pages i-xii Front Matter....Pages 1-1 Modeling Patient Flows Through the Health care System....Pages 3-42 Interdependency of Hospital Departments and Hospital-Wide Patient Flows....Pages 43-63 Hospitals and Clinical Facilities, Processes, and Design for Patient Flow....Pages 65-93 Front Matter....Pages 95-95 Emergency Department Crowding: The Nature of the Problem and Why It Matters....Pages 97-105 The Consequences of Emergency Department Crowding and Delays for Patients....Pages 107-127 Access to Surgery and Medical Consequences of Delays....Pages 129-149 Front Matter....Pages 151-151 Breakthrough Demand–Capacity Management Strategies to Improve Hospital Flow, Safety, and Satisfaction....Pages 153-171 Managing Patient Appointments in Primary Care....Pages 173-196 Waiting Lists for Surgery....Pages 197-227 Triage in Nonemergency Services....Pages 229-250 Front Matter....Pages 251-251 Personnel Staffing and Scheduling....Pages 253-271 Discrete-Event Simulation of Health care Systems....Pages 273-309 Process Mapping of a Regional Trauma System....Pages 311-332 Forecasting Demand for Regional Health Care....Pages 333-359 Queueing Analysis in Health Care....Pages 361-384 Rapid Distribution of Medical Supplies....Pages 385-410 Front Matter....Pages 411-411 Using a Diagnostic to Focus Hospital Flow Improvement Strategies....Pages 413-427 Improving Patient Satisfaction Through Flow....Pages 429-445 Mayo Post Acute Care Program and Care Continuum....Pages 447-472 A Logistics Approach for Hospital Process Improvements....Pages 473-506 Front Matter....Pages 411-411 Managing a Patient Flow Improvement Project....Pages 507-527 Back Matter....Pages 529-553