Neurocritical Care Unit Bed Allocation: Optimization Based on Prioritization Using Simulation

Abstract

Background: Neurological trauma and diseases are the second cause of mortality and the main reason of acquired disability. Neurocritical care plays a major role in treating such patients. A longer life expectancy, treatment of incurable diseases, and limited resources available to add to hospital beds necessitates engineering the knowledge of health systems to prioritize allocation of current resources and present a proper pattern. Objectives: The current study aimed at optimizing bed use and shortening the length of patients` hospitalization in neurocritical care unit (NCCU) of Loghman Hakim hospital affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran, and completely stimulating the procedure of bed allocation and prioritization of patients. Methods: Data of 420 patients hospitalized in NCCU was gathered and the procedure of bed allocation simulation was performed considering the priorities defined based on the length of hospitalization and patients’ chance of survival. The PROMETHEE (preference ranking organization method for enrichment evaluation) method was used to prioritize and allocate beds. To study the consequences of the suggested method, event discrete simulation tool was used to compare the current status and the results of the new method for 20 periods each including one month data. Results: The mean number of patients admitted to NCCU during one month without any prioritization was 76, while it increased to 86 based on prioritization. Conclusions: Patients’ simulation and prioritization using the PROMETHEE method resulted in 13% rise in the number of patients admitted to NCCU and higher utilization of this ward.