title: Modeling the emergency cardiac in-patient flow: an application of queuing theory.
abstract: This study investigates the bottlenecks in the emergency care chain of cardiac in-patient flow. The primary goal is to determine the optimal bed allocation over the care chain given a maximum number of refused admissions. Another objective is to provide deeper insight in the relation between natural variation in arrivals and length of stay and occupancy rates. The strong focus on raising occupancy rates of hospital management is unrealistic and counterproductive. Economies of scale cannot be neglected. An important result is that refused admissions at the First Cardiac Aid (FCA) are primarily caused by unavailability of beds downstream the care chain. Both variability in LOS and fluctuations in arrivals result in large workload variations. Techniques from operations research were successfully used to describe the complexity and dynamics of emergency in-patient flow.
authors.affiliation: Division IV (room PK 6X.185), VU University Medical Centre, De Boelelaan 1117, PO Box 7075, Amsterdam, The Netherlands. am.debruin@vumc.nl
authors.forename: Arnoud M
authors.initials: AM
authors.lastname: de Bruin
authors.forename: A C
authors.initials: AC
authors.lastname: van Rossum
authors.forename: M C
authors.initials: MC
authors.lastname: Visser
authors.forename: G M
authors.initials: GM
authors.lastname: Koole
mesh_terms: D001509:Bed Occupancy / Q000706:statistics & numerical data*; D003325:Coronary Care Units / Q000600:supply & distribution*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D006331:Heart Diseases; D006801:Humans; D007902:Length of Stay; D013598:Systems Theory; D013997:Time Factors