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Improving patient flow in an obstetric unit

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Abstract

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.

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Abbreviations

LOS:

Length of Stay

DRG:

Diagnosis Related Groups

MB:

Mother-baby

AP:

Antepartum

LDR:

Labor, Delivery, and Recovery

PACU:

Post-Anesthesia Care Unit

OR:

Operating Room

EMR:

Electronic Medical Record

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Acknowledgements

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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Authors and Affiliations

  1. H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA

    Jacqueline Griffin, Shuangjun Xia & Pinar Keskinocak

  2. Center for Health Economics and Science Policy, United Biosource Corporation, Bethesda, MA, 20814, USA

    Siyang Peng

Authors
  1. Jacqueline Griffin
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  2. Shuangjun Xia
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  3. Siyang Peng
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  4. Pinar Keskinocak
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Corresponding author

Correspondence to Jacqueline Griffin.

Appendix

Appendix

Table 4 K-S test results for combining MB arrival time data sets according to the probability distribution of time until discharge orders are written (Vaginal delivery patients)
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Table 5 K-S test results for combining MB arrival time data sets according to the probability distribution of time until discharge orders are written (C-section patients)
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Griffin, J., Xia, S., Peng, S. et al. Improving patient flow in an obstetric unit. Health Care Manag Sci 15, 1–14 (2012). https://doi.org/10.1007/s10729-011-9175-6

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