An Integrated Framework for Patient Access Staffing Decision

The challenge of healthcare delivery has attracted widespread attention since the report published by the World Health Organization in 2000, ranking the US 37th in overall health systems performance among 191 Member States. In addition, Davis et al. (2007) demonstrated that healthcare costs in the US were higher than all other countries, despite the fact that care was not the better than all other countries. The growing population in the US, combined with continued medical advances, has increased the demand for quality healthcare services. With this growth, however, comes the challenge of managing rising costs and maintaining efficient operations while satisfying patient's service level. Research has explored methods of improvement from system engineering, lean and process improvement, and mathematical programming of healthcare operations, to improve healthcare operations. In this project, we are interested in a patient access (patient registration) problem. The key research question is: what is an optimal decision in terms of patient admitting points considering both hospital cost and service level of patient access? To answer this question, we propose the use of the Queueing Theory to evaluate scenarios in a multi-objective decision setting implemented by Excel VBA (Visual Basic for Application). The first objective is to provide a "generic" Excel-based model with user-friendly interface such that users are able to visualize outcomes by changing chosen parameters and understand model sensitivities. The second objective is to evaluate the use Queueing in this patient access staffing decision. The data was provided by Healthcare Excellence Institute (HEI), a Phoenix-based consulting company which has experience in improving healthcare operation for more than 8 years. HEI has several hospital clients interested in determining the "optimal" number of admitting points which motivates us to develop this research project. Please note due to business confidentiality, the date used in this thesis has been modified.