Maintaining service level at reduced capacity in hospitals

Hospital management is challenged to deal with conflicting objec- tives of low costs and high quality of care. Erasmus MC is the largest hospital in the Netherlands and will move to another building in a few years time. The hospital aims to keep the service level, consisting of the percentage of waiting patients and average waiting time, constant while reducing the capacity with 30%. In order to determine the ser- vice level, we need to model the patient flow at Erasmus MC. We first provide a thorough data analysis and visualize patient flow using tran- sition probability matrices and diagrams. Discrete event simulation is then used to determine the current service level of the hospital. Simulation results reveal that the capacity reduction will lead to a drastic decrease in the service level. We therefore propose several op- tions that might lead to an increase in the service level. These options include increasing the capacity during the weekend, combining several medical departments and reducing the length of stay. We again use simulation to determine the effectiveness of these measures concerning the service level. All options turn out to increase the service level and we therefore advice the management to implement these solutions.