A discrete event simulation model to support bed management

This is the author accepted manuscript. The final version is available from the publisher via the DOI in this record.In recent years, due to the overcrowding of Emergency Department (ED) and the growing concern in reducing the number of inpatient ward beds, it has become crucial to improve the capacity planning and control activities, which manage the patient flows from EDs to hospital wards. Bed Management has a key role in this context. This study starts by a collaboration with the Local Health Government (LHG) of the Liguria region aimed at studying the impact of supporting bed management with some operational strategies without increasing the bed capacity. A large amount of data was collected over a one-year period at public hospital in Genova and a preliminary observational analysis was conducted to get the main information about the flow of emergency and elective patients from ED to inpatient wards. A Discrete Event Simulation (DES) model has been then developed in order to represent the real system. A scenarios analysis is proposed to assess the best strategy to improve the system performance without increasing bed capacity, by simply synchronizing bed supply and demand. The model can be used as a decision support tool to optimise the use of the available resources as well as to improve the quality of the patient pathway inside the hospital.The authors acknowledge support from the Italian Ministry of Education, University and Research (MIUR), under the grand FIRB n. RBFR081KSB. Data have been made available thanks to a collaboration between ARS Liguria (Dr. Francesco Quaglia and Domenico Gallo) and the Department of Economics and Business, University of Genova