Date of Conferral

2019

Degree

Doctor of Healthcare Administration, DHA

School

Public Policy and Administration

Advisor

Matt Fredericksen-England

Abstract

Hospital systems in the United States are facing a dilemma regarding capacity management in the emergency department (ED) and the inpatient care setting. The average wait time in EDs across the United States exceeds 98 minutes, which is also the point at which patients begin to abandon healthcare treatment. The purpose of this quantitative study was to examine the use of queueing theory in capacity management on length-of-stay (LOS) rates, left-without-being-seen (LWBS) rates, and boarding rates in the ED and inpatient setting. The boarding rates represent the rate in which patients were roomed in the ED but required inpatient care. This study assessed the relationships between capacity management using queueing theory and a reduction in the aforementioned rates compared to traditional processes across systems within the continental United States. A linear regression analysis with a confidence interval 95% paired with an independent sample t test was used to analyze the secondary datasets. A sample size of approximately 33,000 patients was tested in the areas of LOS, LWBS, and boarding. The results of the analysis determined that access was improved in the ED and inpatient setting when queueing theory was deployed within the hospital system compared to traditional processes for managing capacity within the system. Queuing theory used for capacity management resulted in lower LOS, LWBS, and boarding rates. The implications of this study for positive social change include the opportunity to provide greater access to care for the population as a whole, and better health outcomes for the promotion of population health.

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