PubMed · 11680704
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K W Eliceiri, V P Chu, J G White. 2001. LOCal: a flexible web-based microscope reservation system.. https://doi.org/10.2144/01314bt01
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BACKGROUND: Hospital environments are too often characterized by delays for patients receiving diagnostic testing and prolonged waiting times to complete needed therapy. Frequently there is confusion in scheduling, related at least in part to the complex interplay of clinical acuity and highly individualized care. Luther Midelfort recently began to change the process of patient flow to improve access to care, optimize outcomes by enabling timely intervention, and decrease the wasting of resources. UNIT ASSESSMENT TOOL: The hospital developed a unit assessment tool based on the traffic light concept, which consisted of an assessment of current capacity and a graded, color-coded "workload tolerance" for each hospital unit. Each unit can instantly update its own status and query those of other work environments in the hospital. EXPERIENCE WITH THE UNIT ASSESSMENT TOOL: For most of the January-July 2001 period, there was generally a progressive decrease in the percentage of time that the units were coded as red (unit closed to new admissions), with concurrent increases in the percentage of time that the units were coded as green (unit open). Use of the tool appears to have contributed to a dramatic increase in staff satisfaction. SUMMARY AND CONCLUSIONS: The key to regulating patient flow has been to adopt a nursing-initiated capping trust policy whereby nurses are given the authority to limit new admissions. Initiatives are now under way to provide different units with novel models of resource sharing, ranging from flexible housekeeping to "flying nurse squads" to assist units that have become red.
This paper describes the design of a simulation model to provide decision support for the scheduling of patients waiting for elective surgery in the public hospital system. Patients nominated for surgery by doctors are categorised by urgency and type of operation. The simulation model can be used as an operational tool to match hospital availability and patient need. It can also be used to report upon the performance of the system, and as a planning tool to compare the effectiveness of alternative policies in this multi-criteria decision environment.