Dealing with variability in the design, planning and evaluation of Healthcare inpatient units: a modeling methodology for patient dependency variations.

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dc.contributor.author Moris, Matías Urenda
dc.date.accessioned 2010-06-25T15:10:46Z
dc.date.available 2010-06-25T15:10:46Z
dc.date.issued 2010
dc.identifier.uri http://hdl.handle.net/2086/3914
dc.description.abstract This research addresses the fluctuating demand and high variability in healthcare systems. These system’s variations need to be considered whilst at the same time making efficient use of the systems’ resources. Patient dependency fluctuation, which makes determining the level of adequate staffing highly complex, is among the variations addressed. Dealing with variability is found to be a key feature in the design, planning and evaluation of healthcare systems. Healthcare providers are facing increasing challenges resulting from an aging population, higher patient expectancies, a shortage of healthcare professionals, as well as increasing costs and reduced funding. Despite the accentuated need for effective healthcare systems and efficient use of resources, many healthcare organisations are inadequately designed and, moreover, poorly managed. Hospital systems consist of complex interrelations between relatively small units, each of which is sensitive to stochastic variations in demand. In addition to this aspect of the system view, a critical resource for the patients’ wellbeing and survival is the staffing level of nurses. This puts the planning and scheduling of human resources as one of the system’s foremost aims. Current tools for staffing and personnel planning in healthcare organisations do not take into consideration the workload variations that result from the variable nature of patient dependency levels. The work presents the empirical findings of a number of case studies conducted at a regional hospital in Sweden. Principles and practical suggestions for the robust system design of inpatient wards using Discrete Event Simulation (DES) have been identified. Although DES techniques have, in principle, all the features for modelling the variation and stochastic nature of systems, DES has not been previously used for workload studies of inpatient wards. The main contribution of this work is therefore how a combination of DES and the data of Patient Classification Systems (PCSs) can be used to model workload variations and, subsequently, plan the nurse staffing requirements in systems with high variability. The work presented gives step by step guidance in how the analysis and subsequent modelling of an inpatient ward should be carried out. It defines a novel modelling methodology for patient dependency variations and length of stay modelling of a patient’s dependency progression, including an adaptation to the ward’s discharge figures. The modelling approach opens a novel way of analysing and evaluating the system design of inpatient wards. en
dc.description.sponsorship University of Skövde, Sweden en
dc.language.iso en en
dc.publisher De Montfort University en
dc.subject healthcare simulation en
dc.subject patient dependency modelling en
dc.subject healthcare system design en
dc.title Dealing with variability in the design, planning and evaluation of Healthcare inpatient units: a modeling methodology for patient dependency variations. en
dc.type Thesis or dissertation en
dc.publisher.department Mechatronics Research Group en
dc.publisher.department Faculty of Technology en
dc.type.qualificationlevel Doctoral en
dc.type.qualificationname PhD en


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