Interdependency of hospital departments and hospital-wide patient flows

Abstract

This chapter presents a quantitative analysis of patient flows for a typical hospital-wide system that consists of a set of interdependent subsystems: Emergency Department (ED), Intensive Care Unit (ICU), Operating Rooms (OR), and Inpatient Nursing units (NU) including an effect of patient readmission within 30 days of discharge. It is quantitatively demonstrated that local improvement of one subsystem (ED) does not necessarily result in performance and throughput improvement of the entire system. It is also demonstrated that local improvement targets should be aligned to each other in order to prevent unintended consequences of creating another system bottleneck, and worsening the performance of downstream units.