Capacity Balancing Algorithm for Placement of Observation Patients: Assessing the Effect on ED Crowding

Abstract

We examine the queueing performance of a real-time capacity-balancing (CB) algorithm for routing patients from the Emergency Department (ED) to an Observation Unit (OU) or to an inpatient ward. We study the significance of relative bed capacities between the ward and the OU. OUs are designed for specific patient types, with shorter expected hospital stays. By redirecting patients and reserving OU capacity for those who benefit most, overall hospital stay durations are reduced. However, high ward utilization may cause longer ED waiting times. To prevent ED crowding, implementing a CB algorithm requires careful analysis of ward and OU long-run utilization.