Researchers: Amir Elalouf ¹, Yael Perlman ¹, Uri Yechieli ², Jacob Or ³

Background: Bed allocation is critical in emergency departments (EDs) and there are many causes of difficulty in the management of this factor. A method for overcoming the overcrowding problem is the “Floating Patients” method – transferring patients from one department to another or between different hospitals, to balance crowding and reduce length-of-stay. Another method is the addition of armchairs as alternative resources for beds.

Objectives: Improving management effectiveness and reducing patients’ length of stay using Queueing theory models, to check the influence of the addition of armchairs to the EDs and the use of the “Floating Patients” method. Ensuring an optimal allocation of beds/armchairs and a reduction of crowding and length-of-stay in the ED.

Method: Queueing theory models’ development and use of such previous models for optimal application of beds/armchairs allocation and the “Floating Patients” method. Building simulation for cases where the models provide no analytical results. The software simulates many situations and checks solutions for the allocation of beds/armchairs and prioritization of patients.

Findings: Armchairs/beds distribution was checked for various optional levels that are influenced by patients’ arrival rate, ED space in the department and the relevant costs for each specific department. The “Floating Patients” method was checked by a simulation that includes actions currently implemented in the department and was found to balance and reduce crowding loads.

Conclusions: Flexibility of resource management including beds/armchairs and adequate space in the department ameliorate the patients’ admission process. The “Floating Patients” method is effective when the hospitalization departments crowding allows patients admission for evaluation/treatment Thus the method ameliorates the ED service conditions and reduces the waiting times.

Recommendations: Acquisition of optimal working procedures under changing conditions in the department, application of the “Floating Patients” method and of resources management according to the present research – will improve management effectiveness of the ED manager.

Research end date: 02/2019