This project is a joint research effort between Health Services Researchers and Operations Researchers. The aim of this project is to study the use of hospital Transitional Care Units (TCUs) and fuse evidence-based medicine with the mathematical rigor of operations research in developing guidelines on patient care in the TCU. Utilizing datasets from 21 Kaiser Permanente Northern California hospitals, the study will involve a combination of empirical and analytical modeling and analysis. Quantitative models and dynamic optimization algorithms will be developed to identify when a patient should be cared for in the TCU and when he should not be. High fidelity, yet parsimonious, models will be developed based on empirical analysis. Exact analysis of the complex hospital network is likely intractable; hence, dynamic programming tools and approximation techniques will be utilized to develop simple, effective policies. Deliverables include the development of modeling and analytical tools, demonstration and validation via simulation and theoretical analysis, documentation of research results, practitioner education, and research experiences for graduate students.
If successful, the results of this research will provide a framework to analyze and identify best practices for the use of partially flexible resources, hospital Transitional Care Units. This research is of direct interest to healthcare management and physicians. This work will provide insight into the use of TCUs, which is currently very limited. As a joint research agenda between Operations Researchers and Health Services Researchers, this project enables a path from mathematical modeling and analysis to the deployment of the proposed policies and the improvement in medical care. By developing an understanding of how to use a TCU, the care pathways of the hospitals most critical patients can be tailored and optimized. This has important implications for improvement of healthcare provision and is of direct impact to patient themselves and the wider community. Additionally, via seminar outreach and participation in the continuing education programs of physicians and nurses, the medical community will be educated to the benefits of utilizing operations research tools to improve patient care.
