Optimizing the complete care pathway for cerebrovascular accident patients

Cerebrovascular accidents or stroke is an important healthcare concern. For this reason, the need to optimize waiting times along the patient’s diagnostic-therapy care pathway has gained considerable attention in operations management. In this context, the bed-blocking problem is perceived as an important healthcare logistical bottleneck where, although medically ready, the patient cannot transit upstream their care pathway due to unavailable bed resources. In addition, the care pathway is characterized by shifting bottle-necks whereby, optimizing resources at downstream departments often yields considerable waiting time delays for patients transiting further upstream for rehabilitation and nursing home care. This paper addresses these concerns by simulating the stroke patient’s complete pathway, right from arrival at the emergency department and ending at the nursing homes for terminal care. A case study of a large university hospital is presented where intervention strategies aimed at minimizing patient waiting time delays for available bed resources at upstream departments, such rehabilitation wards, and nursing homes are evaluated. The simulation outcomes show that implementing intervention strategies that maximize the bed resource utility, and moreover, implementing buffer management yields considerable improvements in the patients’ waiting time delays.publisher: Elsevier articletitle: Optimising the complete care pathway for cerebrovascular accident patients journaltitle: Computers & Industrial Engineering articlelink: http://dx.doi.org/10.1016/j.cie.2016.01.008 content_type: article copyright: Copyright © 2016 Elsevier Ltd. All rights reserved.status: publishe