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Analysis and optimization of an ambulance offload delay and allocation problem

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  • Almehdawe, Eman
  • Jewkes, Beth
  • He, Qi-Ming

Abstract

Ambulance offload delays have recently become one of the most significant operational challenges for Emergency Medical Services (EMS) providers. Offload delays occur when an ambulance arriving at a hospital Emergency Department (ED) is blocked until a bed becomes available for the patient. To formally investigate the effect of patient routing decisions on EMS offload delays, we introduce a stylized queueing network model with blocking. Following a decomposition approach, we develop an approximation scheme to find explicit solutions that can be used to find proper patient allocation policies to multiple hospitals in a region. We introduce a Markov chain representation for a single ED network and solve for its exact steady state distribution. A comprehensive numerical study is carried out to validate the approximation approaches and to gain insight into ambulance offload delays. By keeping the total offload delays at minimal levels, we observe that it is better to load larger EDs more heavily than smaller ones due to resource pooling.

Suggested Citation

  • Almehdawe, Eman & Jewkes, Beth & He, Qi-Ming, 2016. "Analysis and optimization of an ambulance offload delay and allocation problem," Omega, Elsevier, vol. 65(C), pages 148-158.
    • Handle: RePEc:eee:jomega:v:65:y:2016:i:c:p:148-158
    DOI: 10.1016/j.omega.2016.01.006
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    Cited by:

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    2. Acuna, Jorge A. & Zayas-Castro, José L. & Charkhgard, Hadi, 2020. "Ambulance allocation optimization model for the overcrowding problem in US emergency departments: A case study in Florida," Socio-Economic Planning Sciences, Elsevier, vol. 71(C).
    3. Shuwan Zhu & Wenjuan Fan & Shanlin Yang & Panos M. Pardalos, 2023. "Scheduling operating rooms of multiple hospitals considering transportation and deterioration in mass-casualty incidents," Annals of Operations Research, Springer, vol. 321(1), pages 717-753, February.
    4. Shuwan Zhu & Wenjuan Fan & Xueping Li & Shanlin Yang, 2023. "Ambulance dispatching and operating room scheduling considering reusable resources in mass-casualty incidents," Operational Research, Springer, vol. 23(2), pages 1-37, June.
    5. Shovan Chowdhury, 2019. "On the Estimation of Performance Measures in a Single M/Ek/1 Queue," Working papers 301, Indian Institute of Management Kozhikode.
    6. Li, Mengyu & Vanberkel, Peter & Zhong, Xiang, 2022. "Predicting ambulance offload delay using a hybrid decision tree model," Socio-Economic Planning Sciences, Elsevier, vol. 80(C).
    7. Li, Mengyu & Carter, Alix & Goldstein, Judah & Hawco, Terence & Jensen, Jan & Vanberkel, Peter, 2021. "Determining ambulance destinations when facing offload delays using a Markov decision process," Omega, Elsevier, vol. 101(C).
    8. Mengyu Li & Peter Vanberkel & Alix J. E. Carter, 2019. "A review on ambulance offload delay literature," Health Care Management Science, Springer, vol. 22(4), pages 658-675, December.

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