IDEAS home Printed from https://ideas.repec.org/a/spr/annopr/v178y2010i1p23-4310.1007-s10479-009-0647-8.html
   My bibliography  Save this article

Dimensioning hospital wards using the Erlang loss model

Author

Listed:
  • A. Bruin
  • R. Bekker
  • L. Zanten
  • G. Koole

Abstract

How many beds must be allocated to a specific clinical ward to meet production targets? When budgets get tight, what are the effects of downsizing a nursing unit? These questions are often discussed by medical professionals, hospital consultants, and managers. In these discussions the occupancy rate is of great importance and often used as an input parameter. Most hospitals use the same target occupancy rate for all wards, often 85%. Sometimes an exception is made for critical care and intensive care units. In this paper we demonstrate that this equity assumption is unrealistic and that it might result in an excessive number of refused admissions, particularly for smaller units. Queuing theory is used to quantify this impact. We developed a decision support system, based on the Erlang loss model, which can be used to evaluate the current size of nursing units. We validated this model with hospital data over the years 2004–2006. Finally, we demonstrate the efficiency of merging departments. Copyright The Author(s) 2010

Suggested Citation

  • A. Bruin & R. Bekker & L. Zanten & G. Koole, 2010. "Dimensioning hospital wards using the Erlang loss model," Annals of Operations Research, Springer, vol. 178(1), pages 23-43, July.
    • Handle: RePEc:spr:annopr:v:178:y:2010:i:1:p:23-43:10.1007/s10479-009-0647-8
    DOI: 10.1007/s10479-009-0647-8
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1007/s10479-009-0647-8
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1007/s10479-009-0647-8?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. Kleijnen, J.P.C. & Cheng, R.C.H. & Bettonvil, B.W.M., 2000. "Validation of trace-driven simulation models : More on bootstrap tests," Other publications TiSEM 78dda39d-725a-488b-9618-b, Tilburg University, School of Economics and Management.
    2. Jimmie L. Davis & William A. Massey & Ward Whitt, 1995. "Sensitivity to the Service-Time Distribution in the Nonstationary Erlang Loss Model," Management Science, INFORMS, vol. 41(6), pages 1107-1116, June.
    3. Ward Whitt, 1992. "Understanding the Efficiency of Multi-Server Service Systems," Management Science, INFORMS, vol. 38(5), pages 708-723, May.
    4. Arnoud Bruin & A. Rossum & M. Visser & G. Koole, 2007. "Modeling the emergency cardiac in-patient flow: an application of queuing theory," Health Care Management Science, Springer, vol. 10(2), pages 125-137, June.
    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. Abdelahad Chraibi & Ibrahim H. Osman & Said Kharraja, 2019. "Adaptive layout for operating theatre in hospitals: different mathematical models for optimal layouts," Annals of Operations Research, Springer, vol. 272(1), pages 493-527, January.
    2. Veneklaas, W. & Leeftink, A.G. & van Boekel, P.H.C.M. & Hans, E.W., 2021. "On the design, implementation, and feasibility of hospital admission services: The admission lounge case," Omega, Elsevier, vol. 100(C).
    3. Emily Zhu & Beste Kucukyazici & Yasmina Maizi, 2020. "Designing Observation Units for Heart Failure Patients: Capacity and Patient Flow Considerations," Service Science, INFORMS, vol. 12(1), pages 8-25, March.
    4. Yuta Kanai & Hideaki Takagi, 2021. "Markov chain analysis for the neonatal inpatient flow in a hospital," Health Care Management Science, Springer, vol. 24(1), pages 92-116, March.
    5. Chen, Wanying (Amanda) & De Koster, René B.M. & Gong, Yeming, 2021. "Performance evaluation of automated medicine delivery systems," Transportation Research Part E: Logistics and Transportation Review, Elsevier, vol. 147(C).
    6. Stef Baas & Sander Dijkstra & Aleida Braaksma & Plom Rooij & Fieke J. Snijders & Lars Tiemessen & Richard J. Boucherie, 2021. "Real-time forecasting of COVID-19 bed occupancy in wards and Intensive Care Units," Health Care Management Science, Springer, vol. 24(2), pages 402-419, June.
    7. Yanhong Zou & Jingya Shen & Yuying Chen & Baoyi Zhang, 2023. "Monitoring Urban Expansion (2000–2020) in Yangtze River Delta Using Time-Series Nighttime Light Data and MODIS NDVI," Sustainability, MDPI, vol. 15(12), pages 1-22, June.
    8. Izady, N. & Worthington, D., 2011. "Approximate analysis of non-stationary loss queues and networks of loss queues with general service time distributions," European Journal of Operational Research, Elsevier, vol. 213(3), pages 498-508, September.
    9. Galit B. Yom-Tov & Carri W. Chan, 2021. "Balancing admission control, speedup, and waiting in service systems," Queueing Systems: Theory and Applications, Springer, vol. 97(1), pages 163-219, February.
    10. I. M. H. Vliegen & M. E. Zonderland, 2017. "Game—The BedGame—A Classroom Game Based on Real Healthcare Challenges," INFORMS Transactions on Education, INFORMS, vol. 17(3), pages 128-133, May.
    11. Fermín Mallor & Cristina Azcárate & Julio Barado, 2015. "Optimal control of ICU patient discharge: from theory to implementation," Health Care Management Science, Springer, vol. 18(3), pages 234-250, September.
    12. Hui Zhang & Thomas J. Best & Anton Chivu & David O. Meltzer, 2020. "Simulation-based optimization to improve hospital patient assignment to physicians and clinical units," Health Care Management Science, Springer, vol. 23(1), pages 117-141, March.
    13. Samantha L. Zimmerman & Alexander R. Rutherford & Alexa Waall & Monica Norena & Peter Dodek, 2023. "A queuing model for ventilator capacity management during the COVID-19 pandemic," Health Care Management Science, Springer, vol. 26(2), pages 200-216, June.
    14. Alexander Hübner & Heinrich Kuhn & Manuel Walther, 2018. "Combining clinical departments and wards in maximum-care hospitals," OR Spectrum: Quantitative Approaches in Management, Springer;Gesellschaft für Operations Research e.V., vol. 40(3), pages 679-709, July.
    15. Fermín Mallor & Cristina Azcárate & Julio Barado, 2016. "Control problems and management policies in health systems: application to intensive care units," Flexible Services and Manufacturing Journal, Springer, vol. 28(1), pages 62-89, June.
    16. Shuangchi He & Melvyn Sim & Meilin Zhang, 2019. "Data-Driven Patient Scheduling in Emergency Departments: A Hybrid Robust-Stochastic Approach," Management Science, INFORMS, vol. 65(9), pages 4123-4140, September.
    17. Aleksandra Marcikic Horvat & Branislav Dudic & Boris Radovanov & Boban Melovic & Otilija Sedlak & Monika Davidekova, 2020. "Binary Programming Model for Rostering Ambulance Crew-Relevance for the Management and Business," Mathematics, MDPI, vol. 9(1), pages 1-13, December.
    18. Arne Schulz & Malte Fliedner, 2023. "Minimizing the expected waiting time of emergency jobs," Journal of Scheduling, Springer, vol. 26(2), pages 147-167, April.
    19. David Oakley & Bhakti Stephan Onggo & Dave Worthington, 2020. "Symbiotic simulation for the operational management of inpatient beds: model development and validation using Δ-method," Health Care Management Science, Springer, vol. 23(1), pages 153-169, March.
    20. Hessam Bavafa & Charles M. Leys & Lerzan Örmeci & Sergei Savin, 2019. "Managing Portfolio of Elective Surgical Procedures: A Multidimensional Inverse Newsvendor Problem," Operations Research, INFORMS, vol. 67(6), pages 1543-1563, November.
    21. Amin Mahmoudian-Dehkordi & Somayeh Sadat, 2017. "Sustaining critical care: using evidence-based simulation to evaluate ICU management policies," Health Care Management Science, Springer, vol. 20(4), pages 532-547, December.
    22. Silviya Valeva & Guodong Pang & Andrew J. Schaefer & Gilles Clermont, 2023. "Acuity-Based Allocation of ICU-Downstream Beds with Flexible Staffing," INFORMS Journal on Computing, INFORMS, vol. 35(2), pages 403-422, March.
    23. A. J. Thomas Schneider & P. Luuk Besselink & Maartje E. Zonderland & Richard J. Boucherie & Wilbert B. van den Hout & Job Kievit & Paul Bilars & A. Jaap Fogteloo & Ton J. Rabelink, 2018. "Allocating Emergency Beds Improves the Emergency Admission Flow," Interfaces, INFORMS, vol. 48(4), pages 384-394, August.
    24. Jonas Ingels & Broos Maenhout, 2018. "The impact of overtime as a time-based proactive scheduling and reactive allocation strategy on the robustness of a personnel shift roster," Journal of Scheduling, Springer, vol. 21(2), pages 143-165, April.
    25. Avishai Mandelbaum & Petar Momčilović & Yulia Tseytlin, 2012. "On Fair Routing from Emergency Departments to Hospital Wards: QED Queues with Heterogeneous Servers," Management Science, INFORMS, vol. 58(7), pages 1273-1291, July.

    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. R. Bekker & A. Bruin, 2010. "Time-dependent analysis for refused admissions in clinical wards," Annals of Operations Research, Springer, vol. 178(1), pages 45-65, July.
    2. 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.
    3. Ward Whitt, 1999. "Partitioning Customers into Service Groups," Management Science, INFORMS, vol. 45(11), pages 1579-1592, November.
    4. René Bekker & Paulien Koeleman, 2011. "Scheduling admissions and reducing variability in bed demand," Health Care Management Science, Springer, vol. 14(3), pages 237-249, September.
    5. Achal Bassamboo & J. Michael Harrison & Assaf Zeevi, 2006. "Design and Control of a Large Call Center: Asymptotic Analysis of an LP-Based Method," Operations Research, INFORMS, vol. 54(3), pages 419-435, June.
    6. Marcos Singer & Patricio Donoso & Natalia Jadue, 2004. "Evaluacion De Las Oportunidades De Mejoramiento De La Logistica Directa De Emergencia," Abante, Escuela de Administracion. Pontificia Universidad Católica de Chile., vol. 7(2), pages 179-209.
    7. Tom van Woensel & Frederico R B Cruz, 2014. "Optimal Routing in General Finite Multi-Server Queueing Networks," PLOS ONE, Public Library of Science, vol. 9(7), pages 1-15, July.
    8. Ari Arapostathis & Hassan Hmedi & Guodong Pang, 2021. "On Uniform Exponential Ergodicity of Markovian Multiclass Many-Server Queues in the Halfin–Whitt Regime," Mathematics of Operations Research, INFORMS, vol. 46(2), pages 772-796, May.
    9. 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.
    10. Vyacheslav Abramov, 2006. "Analysis of multiserver retrial queueing system: A martingale approach and an algorithm of solution," Annals of Operations Research, Springer, vol. 141(1), pages 19-50, January.
    11. Mor Harchol-Balter, 2021. "Open problems in queueing theory inspired by datacenter computing," Queueing Systems: Theory and Applications, Springer, vol. 97(1), pages 3-37, February.
    12. Marcus Ang & Karl Sigman & Jing-Sheng Song & Hanqin Zhang, 2017. "Closed-Form Approximations for Optimal ( r , q ) and ( S , T ) Policies in a Parallel Processing Environment," Operations Research, INFORMS, vol. 65(5), pages 1414-1428, October.
    13. 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.
    14. A. J. E. M. Janssen & J. S. H. van Leeuwaarden & Bert Zwart, 2011. "Refining Square-Root Safety Staffing by Expanding Erlang C," Operations Research, INFORMS, vol. 59(6), pages 1512-1522, December.
    15. Venkateshan, Prahalad & Mathur, Kamlesh & Ballou, Ronald H., 2010. "Locating and staffing service centers under service level constraints," European Journal of Operational Research, Elsevier, vol. 201(1), pages 55-70, February.
    16. Josh Reed & Bo Zhang, 2017. "Managing capacity and inventory jointly for multi-server make-to-stock queues," Queueing Systems: Theory and Applications, Springer, vol. 86(1), pages 61-94, June.
    17. Alfonso J. Pedraza-Martinez & Sameer Hasija & Luk N. Van Wassenhove, 2020. "Fleet Coordination in Decentralized Humanitarian Operations Funded by Earmarked Donations," Operations Research, INFORMS, vol. 68(4), pages 984-999, July.
    18. Gustavo Ramiro Rodríguez Jáuregui & Ana Karen González Pérez & Salvador Hernández González & Manuel Darío Hernández Ripalda, 2017. "Analysis of the emergency service applying the queueing theory," Contaduría y Administración, Accounting and Management, vol. 62(3), pages 733-745, Julio-Sep.
    19. Samantha L. Zimmerman & Alexander R. Rutherford & Alexa Waall & Monica Norena & Peter Dodek, 2023. "A queuing model for ventilator capacity management during the COVID-19 pandemic," Health Care Management Science, Springer, vol. 26(2), pages 200-216, June.
    20. Ward Whitt, 2003. "How Multiserver Queues Scale with Growing Congestion-Dependent Demand," Operations Research, INFORMS, vol. 51(4), pages 531-542, 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:spr:annopr:v:178:y:2010:i:1:p:23-43:10.1007/s10479-009-0647-8. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    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.