BOSTON - In the first publication on the application of variability methodology to estimate the direct impact of patient flow variability on access to medical care, doctors at Children's Hospital Boston and professors at Boston University School of Management have identified an encouraging way effective management can improve patient care. They found that variability in scheduled surgical intensive care unit (ICU) caseload represents a potentially reducible source of stress on ICUs in hospitals and throughout the healthcare delivery system.
The study's authors maintain that when variability in intensive care patient scheduling is uncontrolled, it can limit access to care and impair overall responsiveness to emergencies. As a result, the problem of access to intensive care services is prevalent throughout the nation.
The article, published in the June 2003 issue of Anesthesiology and titled "Variability in Surgical Caseload and Access to Intensive Care Services," is authored by Michael L. McManus, M.D., M.P.H., Michael C. Long, M.D., Abbot Cooper, James Mandell, M.D., Donald M. Berwick, M.D. M.P.P., Marcello Pagano, Ph.D., and Eugene Litvak, Ph.D.
After more than a decade of downsizing, many hospitals throughout the country have begun to experience stress related to diminished capacity. This is particularly evident in emergency departments where overcrowding and ambulance diversion are now widely recognized as public health problems threatening national emergency preparedness.
"The study's primary finding is that scheduled patient flow, although theoretically controllable, is counter intuitively more variable than the random demand of emergencies," said Eugene Litvak, Ph.D., Director of the Program on Variability and Professor of Healthcare and Operations Management at Boston University School of Management. "The practical implication is that hospital capacity could be increased and systematic stresses reduced simply by smoothing scheduled p
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Contact: Susan Craig
susan.craig@tch.harvard.edu
617-355-6420
Children's Hospital Boston
2-Jun-2003
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