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Esmaeil Bahalkeh, PhD Student

1. Outpatient Capacity Management for Chronic Diseases: A Model for Multi-specialty Outpatient Clinics

Motivation:

Long waiting time for receiving specialty healthcare services is a worldwide issue. A delayed service can lower the effectiveness of treatments and exacerbate patient’s health condition. Although several studies have focused on access improvement efforts for specific outpatient clinics, there is no generic model to assess the effectiveness of access improvement strategies for specialty and multi-specialty outpatient clinics.      

Description:

The studied multi-specialty memory clinic is a comprehensive outpatient clinic for memory disorders that offers diagnosis and treatment services for multiple patient populations. Unlike conventional outpatient clinics that mainly serve one patient population, the studied multi-specialty memory clinic serves six types of patients: memory new, memory revisit, neurology initial consultation, neurology follow-up, geriatric psychiatric initial consultation, and geriatric psychiatric follow-up. Although memory, neurology and geriatric psychiatric populations represent independent characteristics, they interact with each other in multiple forms. Shared space and human resources (registrar, medical assistant) can also influence such interactions.

Bahalkeh graphic 1: Memory New Patients

After extensive queue performance analysis on retrospective visits data, we developed a stochastic optimization model for identifying optimal interventions. An empirically based discrete-event simulation was then combined with the optimization problem.

Bahalkeh graphic 2: Memory Patients

Bahalkeh graphic #3: Memory Revisit Patients

Conclusions:

Despite the myth, we showed that expanding capacity through increasing provider hours is the least effective strategy for improving patient access. In fact, investing on process improvement efforts such as scheduling policy, overbooking, and reducing revisits can significantly improve access. Furthermore, we developed a generic algorithm to identify effective access improvement strategies for any outpatient clinic. 

Outcome:

Evaluating the Effectiveness of Access Improvement Strategies for a Multidisciplinary Outpatient Clinic, submitted

Defining Patient Access to Specialty Outpatient Clinics: A Case Study Across Six Specialty Clinics, working paper   

Collaborators:

Yuehwern Yih, PhD

Tze C. Chiam, PhD

James M. Ellison, MD, MPH

Value Institute, Christiana Care Health System

Logo of Christiana Health

2. Inpatient Capacity Management: An Integrated Approach for Hospital Units

Motivation:

Surge capacity and performing under congestion can impact patient experience and overall performance of the hospital. In spite of the existing rich literature on inpatient capacity management, only handful of studies have mentioned the importance of taking a holistic approach toward the issue.

Description:

The studied major academic hospital consists of multiple units that patients flow through them. To improve patient experience and to achieve a better overall performance, we develop a data-driven stochastic optimization model that determines the short-term and long-term capacity levels for each unit.  

Bahalkeh graphic #5

Outcome:

Improving Patient Flow in Hospitals: State of the Art, Challenges and Opportunities, working paper

Where do I Belong? Redefining Patient Groups in Hospitals, working paper

Collaborators:

Yuehwern Yih, PhD

Tze C. Chiam, PhD

Value Institute, Christiana Care Health System

Bahalkeh graphic #6: Value Institute, Christiana Care Health logo