Patient Mix Optimization in Admission Planning under Multitype Patients and Priority Constraints

Hospital beds are one of the most critical medical resources. Large hospitals in China have caused bed utilization rates to exceed 100% due to long-term extra beds. To alleviate the contradiction between the supply of high-quality medical resources and the demand for hospitalization, in this paper, we address the decision of choosing a case mix for a respiratory medicine department. We aim to generate an optimal admission plan of elective patients with the stochastic length of stay and different resource consumption. We assume that we can classify elective patients according to their registration information before admission. We formulated a general integer programming model considering heterogeneous patients and introducing patient priority constraints. The mathematical model is used to generate a scientific and reasonable admission planning, determining the best admission mix for multitype patients in a period. Compared with model II that does not consider priority constraints, model I proposed in this paper is better in terms of admissions and revenue. The proposed model I can adjust the priority parameters to meet the optimal output under different goals and scenarios. The daily admission planning for each type of patient obtained by model I can be used to assist the patient admission management in large general hospitals.

A web-based system for booking patients for hospital admission to the orthopedic department (Preprint)

BACKGROUND Poor management efficiency in the Polish health system requires the use of patient information systems that have been in operation for several years. However, their heterogeneity and technological and functional diversity pose a challenge. Not only do systems of different companies differ from each other, but within the same solution, there are shortcomings or differences in functional modules across different units of the health sector. These are due to variations in demands related to the specifics of the unit. OBJECTIVE Therefore, the lack of appropriate tools for planning patient admissions in the present hospital information system, the current failure of paper management methods, and the lack of tools at the ready to create our own have forced the implementation of commercial solutions. METHODS An Admission of Patient Program based on the browser is available on devices connected only to the hospital network. The program used the online FullCalendar library and the MySQL database. RESULTS The system is based on the form of a calendar with the possibility of editing a patient's records planned for a given day of admission. It is intuitive and easy to use. It is a transparent program, thanks to the use of color styles in the records. CONCLUSIONS Conclusions. After 2 years, the system works efficiently and is a significant facilitator of the management of patient admission planning, which translates into the appropriate use of branch resources (number of staff and hospital beds) and optimization of operating room usage.

Decreasing initiation of chemotherapy time in elective patients admitted to an inpatient hematology malignancy unit.

120 Background: At our institution, we observed that 86% (n = 25) of patients admitted for elective chemotherapy experienced a delay (greater than 6 hours) in initiating their treatment. Methods: We measured time from admission to chemotherapy administration (Defined from time of vital signs taken at admission until time of chemotherapy administration) in patients admitted for elective chemotherapy. Key process measures were identified and monitored (i.e, time from admission to laboratory exam results, time from admission to chemotherapy signed, time from chemotherapy signed to chemotherapy released by nurse from the EMR). We collected data every two weeks. After collecting data and utilizing performance improvement tools such as a pareto chart and PICK chart, we developed multiple PDSA cycles as described in Table 1. Results: At the time of interim analysis, we observed a median decrease in time to chemotherapy administration from 25 hours to 8.85 hours. Median time to lab draws decreased from 2.33 hours to -0.63 hours. There was no change in time from signature to nurse releasing the chemotherapy. We noticed more providers were signing the chemotherapy prior to patient admission and more patients were receiving pre-admission alkalinization strategies. Conclusions: By implementing new admission workflows, optimizing our use of the EMR to communicate among providers, and improving pre-admission planning we were able to reduce our time to chemotherapy for elective admissions by 64.6%. Improvement still needed to meet our goals and fully standardize the processes as part of our daily workflow.[Table: see text]

Patient Health Goals Elicited During Home Care Admission: A Categorization

Home care agencies are initiating “patient health goal elicitation” activities as part of home care admission planning. We categorized elicited goals and identified “clinically informative” goals at a home care agency. We examined patient goals that admitting clinicians documented in the point-of-care electronic health record; conducted content analysis on patient goal data to develop a coding scheme; grouped goal themes into codes; assigned codes to each goal; and identified goals that were in the patient voice. Of the 1,763 patient records, 16% lacked a goal; only 15 goals were in a patient’s voice. Nurse and physician experts identified 12 of the 20 codes as clinically important accounting for 82% of goal occurrences. The most frequent goal documented was safety/falls (23%). Training and consistent communication of the intent and operationalization of patient goal elicitation may address the absence of patient voice and the less than universal recording of home care patients’ goals.