IDEAS home Printed from https://ideas.repec.org/a/eee/ejores/v261y2017i3p1110-1124.html
   My bibliography  Save this article

Fluid approximations and control of queues in emergency departments

Author

Listed:
  • Niyirora, Jerome
  • Zhuang, Jun

Abstract

Long queues in emergency departments (EDs) lead to overcrowding, a phenomenon that can potentially compromise patient care when medical interventions are delayed. There are several causes of this problem, one of which is inadequate resource allocation. In this paper, we propose using a modified version of the square root staffing (SRS) rule to satisfy the probability of delay target. We use the concepts of kinetics and biological modeling to approximate the fluid behavior of the queueing process. We are then able to estimate the offered load and the appropriate service grade necessary to construct a staffing policy that meets the target. Additionally, we show how to utilize Pontryagin’s maximum principle to find the optimal number of providers that minimizes delay and staffing costs. Finally, we demonstrate the implementation of our model using data from a hospital in upstate New York.

Suggested Citation

  • Niyirora, Jerome & Zhuang, Jun, 2017. "Fluid approximations and control of queues in emergency departments," European Journal of Operational Research, Elsevier, vol. 261(3), pages 1110-1124.
  • Handle: RePEc:eee:ejores:v:261:y:2017:i:3:p:1110-1124
    DOI: 10.1016/j.ejor.2017.03.013
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0377221717301996
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.ejor.2017.03.013?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Stephen G. Eick & William A. Massey & Ward Whitt, 1993. "The Physics of the Mt/G/∞ Queue," Operations Research, INFORMS, vol. 41(4), pages 731-742, August.
    2. Linda Green & Peter Kolesar, 1991. "The Pointwise Stationary Approximation for Queues with Nonstationary Arrivals," Management Science, INFORMS, vol. 37(1), pages 84-97, January.
    3. Michael McAsey & Libin Mou & Weimin Han, 2012. "Convergence of the forward-backward sweep method in optimal control," Computational Optimization and Applications, Springer, vol. 53(1), pages 207-226, September.
    4. Jens Brunner & Jonathan Bard & Rainer Kolisch, 2009. "Flexible shift scheduling of physicians," Health Care Management Science, Springer, vol. 12(3), pages 285-305, September.
    5. Izady, Navid & Worthington, Dave, 2012. "Setting staffing requirements for time dependent queueing networks: The case of accident and emergency departments," European Journal of Operational Research, Elsevier, vol. 219(3), pages 531-540.
    6. Ramirez-Nafarrate, Adrian & Baykal Hafizoglu, A. & Gel, Esma S. & Fowler, John W., 2014. "Optimal control policies for ambulance diversion," European Journal of Operational Research, Elsevier, vol. 236(1), pages 298-312.
    7. Tirdad, Ali & Grassmann, Winfried K. & Tavakoli, Javad, 2016. "Optimal policies of M(t)/M/c/c queues with two different levels of servers," European Journal of Operational Research, Elsevier, vol. 249(3), pages 1124-1130.
    8. Yann Ferrand & Michael Magazine & Uday S. Rao & Todd F. Glass, 2011. "Building Cyclic Schedules for Emergency Department Physicians," Interfaces, INFORMS, vol. 41(6), pages 521-533, December.
    9. William A. Massey & Ward Whitt, 1996. "Stationary-Process Approximations for the Nonstationary Erlang Loss Model," Operations Research, INFORMS, vol. 44(6), pages 976-983, December.
    10. Ward Whitt, 2005. "Engineering Solution of a Basic Call-Center Model," Management Science, INFORMS, vol. 51(2), pages 221-235, February.
    11. Caputo,Michael R., 2005. "Foundations of Dynamic Economic Analysis," Cambridge Books, Cambridge University Press, number 9780521842723, January.
    12. David Sinreich & Ola Jabali, 2007. "Staggered work shifts: a way to downsize and restructure an emergency department workforce yet maintain current operational performance," Health Care Management Science, Springer, vol. 10(3), pages 293-308, September.
    13. Noah Gans & Ger Koole & Avishai Mandelbaum, 2003. "Telephone Call Centers: Tutorial, Review, and Research Prospects," Manufacturing & Service Operations Management, INFORMS, vol. 5(2), pages 79-141, September.
    14. Ahmed, Mohamed A. & Alkhamis, Talal M., 2009. "Simulation optimization for an emergency department healthcare unit in Kuwait," European Journal of Operational Research, Elsevier, vol. 198(3), pages 936-942, November.
    15. Eva K. Lee & Hany Y. Atallah & Michael D. Wright & Eleanor T. Post & Calvin Thomas & Daniel T. Wu & Leon L. Haley, 2015. "Transforming Hospital Emergency Department Workflow and Patient Care," Interfaces, INFORMS, vol. 45(1), pages 58-82, February.
    16. Nobel, Rein D. & Tijms, Henk C., 1999. "Optimal control for an MX/G/1 queue with two service modes," European Journal of Operational Research, Elsevier, vol. 113(3), pages 610-619, March.
    17. Seidl, Andrea & Kaplan, Edward H. & Caulkins, Jonathan P. & Wrzaczek, Stefan & Feichtinger, Gustav, 2016. "Optimal control of a terror queue," European Journal of Operational Research, Elsevier, vol. 248(1), pages 246-256.
    18. Mielczarek, Bożena, 2014. "Simulation modelling for contracting hospital emergency services at the regional level," European Journal of Operational Research, Elsevier, vol. 235(1), pages 287-299.
    19. Yunan Liu & Ward Whitt, 2012. "Stabilizing Customer Abandonment in Many-Server Queues with Time-Varying Arrivals," Operations Research, INFORMS, vol. 60(6), pages 1551-1564, December.
    20. Galit B. Yom-Tov & Avishai Mandelbaum, 2014. "Erlang-R: A Time-Varying Queue with Reentrant Customers, in Support of Healthcare Staffing," Manufacturing & Service Operations Management, INFORMS, vol. 16(2), pages 283-299, May.
    21. Shlomo Halfin & Ward Whitt, 1981. "Heavy-Traffic Limits for Queues with Many Exponential Servers," Operations Research, INFORMS, vol. 29(3), pages 567-588, June.
    22. Abo-Hamad, Waleed & Arisha, Amr, 2013. "Simulation-based framework to improve patient experience in an emergency department," European Journal of Operational Research, Elsevier, vol. 224(1), pages 154-166.
    23. Wang, Jinting & Zhang, Xuelu & Huang, Ping, 2017. "Strategic behavior and social optimization in a constant retrial queue with the N-policy," European Journal of Operational Research, Elsevier, vol. 256(3), pages 841-849.
    24. Luscombe, Ruth & Kozan, Erhan, 2016. "Dynamic resource allocation to improve emergency department efficiency in real time," European Journal of Operational Research, Elsevier, vol. 255(2), pages 593-603.
    25. Li, Na & Stanford, David A., 2016. "Multi-server accumulating priority queues with heterogeneous servers," European Journal of Operational Research, Elsevier, vol. 252(3), pages 866-878.
    26. Yarmand, Mohammad H. & Down, Douglas G., 2013. "Server allocation for zero buffer tandem queues," European Journal of Operational Research, Elsevier, vol. 230(3), pages 596-603.
    27. Otis B. Jennings & Avishai Mandelbaum & William A. Massey & Ward Whitt, 1996. "Server Staffing to Meet Time-Varying Demand," Management Science, INFORMS, vol. 42(10), pages 1383-1394, October.
    28. Opher Baron & Joseph Milner, 2009. "Staffing to Maximize Profit for Call Centers with Alternate Service-Level Agreements," Operations Research, INFORMS, vol. 57(3), pages 685-700, June.
    29. Yisha Xiang & Jun Zhuang, 2016. "A medical resource allocation model for serving emergency victims with deteriorating health conditions," Annals of Operations Research, Springer, vol. 236(1), pages 177-196, January.
    30. Stolletz, Raik, 2008. "Approximation of the non-stationary M(t)/M(t)/c(t)-queue using stationary queueing models: The stationary backlog-carryover approach," European Journal of Operational Research, Elsevier, vol. 190(2), pages 478-493, October.
    31. Liu, Yunan & Whitt, Ward, 2017. "Stabilizing performance in a service system with time-varying arrivals and customer feedback," European Journal of Operational Research, Elsevier, vol. 256(2), pages 473-486.
    32. Koeleman, P.M. & Bhulai, S. & van Meersbergen, M., 2012. "Optimal patient and personnel scheduling policies for care-at-home service facilities," European Journal of Operational Research, Elsevier, vol. 219(3), pages 557-563.
    33. Dimitrakopoulos, Y. & Burnetas, A.N., 2016. "Customer equilibrium and optimal strategies in an M/M/1 queue with dynamic service control," European Journal of Operational Research, Elsevier, vol. 252(2), pages 477-486.
    34. Shioyama, Tadayoshi, 1991. "Optimal control of a queuing network system with two types of customers," European Journal of Operational Research, Elsevier, vol. 52(3), pages 367-372, June.
    35. Huguette Beaulieu & Jacques Ferland & Bernard Gendron & Philippe Michelon, 2000. "A mathematical programming approach for scheduling physicians in the emergency room," Health Care Management Science, Springer, vol. 3(3), pages 193-200, June.
    36. Louis-Martin Rousseau & Gilles Pesant & Michel Gendreau, 2002. "A General Approach to the Physician Rostering Problem," Annals of Operations Research, Springer, vol. 115(1), pages 193-205, September.
    37. Defraeye, Mieke & Van Nieuwenhuyse, Inneke, 2016. "Staffing and scheduling under nonstationary demand for service: A literature review," Omega, Elsevier, vol. 58(C), pages 4-25.
    38. Zohar Feldman & Avishai Mandelbaum & William A. Massey & Ward Whitt, 2008. "Staffing of Time-Varying Queues to Achieve Time-Stable Performance," Management Science, INFORMS, vol. 54(2), pages 324-338, February.
    39. Michael C. Fu & Steven I. Marcus & I-Jeng Wang, 2000. "Monotone Optimal Policies for a Transient Queueing Staffing Problem," Operations Research, INFORMS, vol. 48(2), pages 327-331, April.
    40. Atul Bhandari & Alan Scheller-Wolf & Mor Harchol-Balter, 2008. "An Exact and Efficient Algorithm for the Constrained Dynamic Operator Staffing Problem for Call Centers," Management Science, INFORMS, vol. 54(2), pages 339-353, February.
    41. Sem Borst & Avi Mandelbaum & Martin I. Reiman, 2004. "Dimensioning Large Call Centers," Operations Research, INFORMS, vol. 52(1), pages 17-34, February.
    42. O. Garnet & A. Mandelbaum & M. Reiman, 2002. "Designing a Call Center with Impatient Customers," Manufacturing & Service Operations Management, INFORMS, vol. 4(3), pages 208-227, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Pei, Zhi & Dai, Xu & Yuan, Yilun & Du, Rui & Liu, Changchun, 2021. "Managing price and fleet size for courier service with shared drones," Omega, Elsevier, vol. 104(C).
    2. Legros, Benjamin, 2021. "Routing analyses for call centers with human and automated services," International Journal of Production Economics, Elsevier, vol. 240(C).
    3. Jaime González & Juan-Carlos Ferrer & Alejandro Cataldo & Luis Rojas, 2019. "A proactive transfer policy for critical patient flow management," Health Care Management Science, Springer, vol. 22(2), pages 287-303, June.
    4. Benjamin Legros, 2021. "Routing analyses for call centers with human and automated services," Post-Print hal-03605426, HAL.
    5. Abhishek, & Legros, Benjamin & Fransoo, Jan C., 2021. "Performance evaluation of stochastic systems with dedicated delivery bays and general on-street parking," Other publications TiSEM 09ed9572-d59c-4f28-a9c4-b, Tilburg University, School of Economics and Management.
    6. Morgan, Lucy E. & Barton, Russell R., 2022. "Fourier trajectory analysis for system discrimination," European Journal of Operational Research, Elsevier, vol. 296(1), pages 203-217.
    7. A. Mustafin & A. Kantarbayeva, 2022. "Clearing function in the context of the invariant manifold method," Papers 2206.11205, arXiv.org.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Defraeye, Mieke & Van Nieuwenhuyse, Inneke, 2016. "Staffing and scheduling under nonstationary demand for service: A literature review," Omega, Elsevier, vol. 58(C), pages 4-25.
    2. Jerome Niyirora & Jamol Pender, 2016. "Optimal staffing in nonstationary service centers with constraints," Naval Research Logistics (NRL), John Wiley & Sons, vol. 63(8), pages 615-630, December.
    3. Ran Liu & Xiaolan Xie, 2018. "Physician Staffing for Emergency Departments with Time-Varying Demand," INFORMS Journal on Computing, INFORMS, vol. 30(3), pages 588-607, August.
    4. Eugene Furman & Adam Diamant & Murat Kristal, 2021. "Customer Acquisition and Retention: A Fluid Approach for Staffing," Production and Operations Management, Production and Operations Management Society, vol. 30(11), pages 4236-4257, November.
    5. Xi Chen & Dave Worthington, 2017. "Staffing of time-varying queues using a geometric discrete time modelling approach," Annals of Operations Research, Springer, vol. 252(1), pages 63-84, May.
    6. Erhard, Melanie & Schoenfelder, Jan & Fügener, Andreas & Brunner, Jens O., 2018. "State of the art in physician scheduling," European Journal of Operational Research, Elsevier, vol. 265(1), pages 1-18.
    7. Opher Baron & Joseph Milner, 2009. "Staffing to Maximize Profit for Call Centers with Alternate Service-Level Agreements," Operations Research, INFORMS, vol. 57(3), pages 685-700, June.
    8. J. G. Dai & Pengyi Shi, 2017. "A Two-Time-Scale Approach to Time-Varying Queues in Hospital Inpatient Flow Management," Operations Research, INFORMS, vol. 65(2), pages 514-536, April.
    9. Liu, Yunan & Whitt, Ward, 2017. "Stabilizing performance in a service system with time-varying arrivals and customer feedback," European Journal of Operational Research, Elsevier, vol. 256(2), pages 473-486.
    10. William A. Massey & Jamol Pender, 2018. "Dynamic rate Erlang-A queues," Queueing Systems: Theory and Applications, Springer, vol. 89(1), pages 127-164, June.
    11. Pei, Zhi & Dai, Xu & Yuan, Yilun & Du, Rui & Liu, Changchun, 2021. "Managing price and fleet size for courier service with shared drones," Omega, Elsevier, vol. 104(C).
    12. J. Michael Harrison & Assaf Zeevi, 2005. "A Method for Staffing Large Call Centers Based on Stochastic Fluid Models," Manufacturing & Service Operations Management, INFORMS, vol. 7(1), pages 20-36, September.
    13. Yongkyu Cho & Young Myoung Ko, 2020. "Stabilizing the virtual response time in single-server processor sharing queues with slowly time-varying arrival rates," Annals of Operations Research, Springer, vol. 293(1), pages 27-55, October.
    14. Schwarz, Justus Arne & Selinka, Gregor & Stolletz, Raik, 2016. "Performance analysis of time-dependent queueing systems: Survey and classification," Omega, Elsevier, vol. 63(C), pages 170-189.
    15. Noa Zychlinski, 2023. "Applications of fluid models in service operations management," Queueing Systems: Theory and Applications, Springer, vol. 103(1), pages 161-185, February.
    16. Barış Ata & Xiaoshan Peng, 2020. "An Optimal Callback Policy for General Arrival Processes: A Pathwise Analysis," Operations Research, INFORMS, vol. 68(2), pages 327-347, March.
    17. Guodong Pang & Ward Whitt, 2009. "Service Interruptions in Large-Scale Service Systems," Management Science, INFORMS, vol. 55(9), pages 1499-1512, September.
    18. Avishai Mandelbaum & Sergey Zeltyn, 2009. "Staffing Many-Server Queues with Impatient Customers: Constraint Satisfaction in Call Centers," Operations Research, INFORMS, vol. 57(5), pages 1189-1205, October.
    19. Zohar Feldman & Avishai Mandelbaum & William A. Massey & Ward Whitt, 2008. "Staffing of Time-Varying Queues to Achieve Time-Stable Performance," Management Science, INFORMS, vol. 54(2), pages 324-338, February.
    20. Mor Armony & Constantinos Maglaras, 2004. "Contact Centers with a Call-Back Option and Real-Time Delay Information," Operations Research, INFORMS, vol. 52(4), pages 527-545, August.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:ejores:v:261:y:2017:i:3:p:1110-1124. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/eor .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.