Health Care Management Science

, Volume 15, Issue 1, pp 1–14 | Cite as

Improving patient flow in an obstetric unit

  • Jacqueline Griffin
  • Shuangjun Xia
  • Siyang Peng
  • Pinar Keskinocak


Hospitals have become increasingly interested in maximizing patient throughput and bed utilization in all units to improve efficiency. To study tradeoffs in blocking and system efficiency, a simulation model using a path-based approach is developed for an obstetric unit. The model focuses on patient flow, considering patient classification, blocking effects, time dependent arrival and departure patterns, and statistically supported distributions for length of stay (LOS). The model is applied to DeKalb Medical’s Women’s Center, a large obstetrics hospital in Atlanta, GA, to analyze the hospital’s readiness for potential changes to patient mix and patient volume. A comparison of results predicted by the simulation model and actual performance after implementation of “swing” rooms is presented, suggesting the value of implementing “swing” rooms to balance bed allocation.


Obstetric Patient flow Simulation Blocking Bed-balancing 



Length of Stay


Diagnosis Related Groups






Labor, Delivery, and Recovery


Post-Anesthesia Care Unit


Operating Room


Electronic Medical Record



The authors would like to thank Ms. Cathleen Wheatley RN and Ms. Margie Hunter RN, of DeKalb Medical, for making this project possible. The authors would also like to thank Mr. Chris Kirkpatrick and Ms. Michele Ballagh for their support in data collection, and thank all the staff of DeKalb Medical’s Women’s Center for the many insightful discussions relating to obstetric patient flow and for their continued support and vision. This research has been supported in part by the Mary Anne and Harold R. Nash Endowment at Georgia Tech.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Jacqueline Griffin
    • 1
  • Shuangjun Xia
    • 1
  • Siyang Peng
    • 2
  • Pinar Keskinocak
    • 1
  1. 1.H. Milton Stewart School of Industrial and Systems EngineeringGeorgia Institute of TechnologyAtlantaUSA
  2. 2.Center for Health Economics and Science PolicyUnited Biosource CorporationBethesdaUSA

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