The efficient utilization and management of a scarce resource such as the intensive care unit (ICU) is critical to the smooth functioning of a hospital. This study investigates the impact of a set of operational policies on ICU behavior and performance. Specifically, the implemented policies are (a) wait time thresholds on how long patients can wait for an ICU bed, (b) the time windows during which patient discharges and transfers take place, and (c) different patient mix combinations. The average waiting time of patients for ICU beds and the admission ratio, the ratio of admitted patients to total ICU bed requests, are the performance measures under consideration. Using discrete event simulation, followed by analysis of variance and post hoc tests (Tukey multiple comparison), it is shown that increasing discharge windows has a statistically significant impact on the total number of admissions and average patient wait times. Moreover, average waiting time increased when wait time thresholds increased, especially when the number of emergency surgeries in the mix increased. In addition, larger proportions of elective surgery patients in the patient mix population can lead to significantly reduced ICU performance.

中文翻译：

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使用离散事件模拟模型评估重症监护病房的入院和出院政策

有效利用和管理重症监护病房 (ICU) 等稀缺资源对于医院的顺利运作至关重要。本研究调查了一组操作策略对 ICU 行为和性能的影响。具体而言，实施的政策是 (a) 患者可以等待 ICU 病床多长时间的等待时间阈值，(b) 患者出院和转院的时间窗口，以及 (c) 不同的患者组合组合。ICU病床患者的平均等待时间和入住率，即入住患者占ICU床位总数的比例，是正在考虑的绩效指标。使用离散事件模拟，然后进行方差分析和事后检验（Tukey 多重比较），结果表明，增加出院窗口对入院总数和平均患者等待时间具有统计学意义的影响。此外，当等待时间阈值增加时，平均等待时间也会增加，尤其是当混合中的急诊手术数量增加时。此外，患者组合人群中较大比例的择期手术患者会导致 ICU 性能显着降低。