Models as instruments for optimizing hospital processes: a systematic review.
OBJECTIVE
The purpose of this article is to find decision-making models for the design and control of processes regarding patient flows, considering various problem types, and to find out how usable these models are for managerial decision making.


METHODS
A systematic review of the literature was carried out. Relevant literature from three databases was selected based on inclusion and exclusion criteria and the results were analyzed.


RESULTS
A total of 68 articles were selected. Of these, 31 contained computer simulation models, ten contained descriptive models, and 27 contained analytical models. The review showed that descriptive models are only applied to process design problems, and that analytical and computer simulation models are applied to all types of problems to approximately the same extent. Only a few models have been validated in practice, and it seems that most models are not used for their intended purpose: to support management in decision making.


CONCLUSIONS
The comparability of the relevant databases appears to be limited and there is an insufficient number of suitable keywords and MeSH headings, which makes searching systematically within the broad field of health care management relatively hard to accomplish.


CONCLUSIONS
The findings give managers insight into the characteristics of various types of decision-support models and into the kinds of situations in which they are used.


CONCLUSIONS
This is the first time literature on various kinds of models for supporting managerial decision making in hospitals has been systematically collected and assessed.
Department of Quality and Process Innovation, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. j.r.vansambeek@amc.uva.nl
J R C
JR
van Sambeek
F A
FA
Cornelissen
P J M
PJ
Bakker
J J
JJ
Krabbendam
D003661:Decision Support Techniques; D006739:Hospital Administration; D006801:Humans; D010043:Outcome and Process Assessment, Health Care / Q000379:methods; D011785:Quality Assurance, Health Care / Q000379:methods*; D013597:Systems Analysis