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Emergency care at breaking point

The Institute of Medicine, one of the National Academies, has a series of reports out about the state of emergency medical care in the United States. The report is scathing in its assessment:

Despite the lifesaving feats performed every day by emergency departments and ambulance services, the nation’s emergency medical system as a whole is overburdened, underfunded, and highly fragmented, says this series of three reports from the Institute of Medicine.

As a result, ambulances are turned away from emergency departments once every minute on average and patients in many areas may wait hours or even days for a hospital bed. Moreover, the system is ill-prepared to handle surges from disasters such as hurricanes, terrorist attacks, or disease outbreaks.

The full reports are available for purchase, but there is a report brief that summarizes the main conclusions. The number one recommendation for fixing these problems? Use operations research, of course:

Tools developed from engineering and operations research have been successfully applied to a variety of businesses, from banking and airlines to manufacturing companies. These same tools have been shown to improve the flow of patients through hospitals, increasing the number of patients that can be treated while minimizing delays in their treatment and improving the quality of their care. One such tool is queuing theory, which by smoothing the peaks and valleys of patient admissions has the potential to eliminate bottlenecks, reduce crowding, improve patient care, and reduce cost. Another promising tool is the clinical decision unit, or 23-hour observation unit, which helps ED [Emergency Department] staff determine whether certain ED patients require admission. Hospitals should use these tools as a way of improving hospital efficiency and, in particular, reducing ED crowding.

This is exactly the sort of problem where a bit of OR can go a long way.

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