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Bed blocking in hospitals : simulation of the transmural care chain

Brakel, Paula van (2010) Bed blocking in hospitals : simulation of the transmural care chain.

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Abstract:Problem description: This research is done in the general hospital Reinier de Graaf Groep (RdGG). RdGG, just like many hospitals, has to deal with the problem of bed blocking: patients who need no further medical treatment are waiting in the hospital for aftercare. The congestion of departments by bed blocking has a negative impact on both costs and service level of the provided care. Contradicting financial objectives of nursing homes and hospitals make this a continuous problem. Nursing homes aim at maximising bed occupation, while hospitals aim for maximum bed availability at nursing homes. Increased availability of nursing home beds allows patients who do not require further medical care to go to a nursing home, so it becomes possible to admit new patients in the hospital. The impact of every extra day spent in the hospital increases with the trend of decreasing lengths of stay in hospital care. Bed blocking can be caused by lack of transparency and bad communication processes between the hospital and cooperating nursing homes. On the other hand, lack of available nursing home beds causes bed blocking. Fluctuations in demand and patient preferences for specific nursing homes, in turn, hinder balancing occupation. In the literature, little research is available on how to integrate care needs that span over different care providers. We study the dynamics of a smooth and timely flow of patients from a hospital towards nursing homes. Objective: To design a tool that allows analysis of various configurations of transmural networks, in order to minimise bed blocking. The study explores interventions of bed reservation by hospitals and of (temporary) reallocating capacity to other patient categories. The main performance indicators we use are waiting time (bed blocking days), occupation of nursing home departments and throughput of nursing homes.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:85 business administration, organizational science
Programme:Business Administration MSc (60644)
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