dorsal/arxiv
View SchemaEmergency Department Patient Flow Optimization with an Alternative Care Threshold Policy
| Authors | Sahba Baniasadi, Paul M. Griffin, Prakash Chakraborty |
|---|---|
| Categories | |
| ArXiv ID | 2601.10041vv1 |
| URL | https://arxiv.org/abs/2601.10041 |
| License | http://creativecommons.org/licenses/by-nc-nd/4.0/ |
Abstract
Emergency department (ED) overcrowding and patient boarding represent critical systemic challenges that compromise care quality. We propose a threshold-based admission policy that redirects non-urgent patients to alternative care pathways, such as telemedicine, during peak congestion. The ED is modeled as a two-class $M/M/c$ preemptive-priority queuing system, where high-acuity patients are prioritized and low-acuity patients are subject to state-dependent redirection. Analyzed via a level-dependent Quasi-Birth-Death (QBD) process, the model determines the optimal threshold by maximizing a long-run time-averaged objective function comprising redirection-affected revenue and costs associated with patient balking and system occupancy. Numerical analysis using national healthcare data reveals that optimal policies are highly context-dependent. While rural EDs generally optimize at lower redirection thresholds, urban EDs exhibit performance peaks at moderate thresholds. Results indicate that our optimal policy yields significant performance gains of up to $4.84\%$ in rural settings and $5.90\%$ in urban environments. This research provides a mathematically rigorous framework for balancing clinical priority with operational efficiency across diverse ED settings.
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"abstract": "Emergency department (ED) overcrowding and patient boarding represent critical systemic challenges that compromise care quality. We propose a threshold-based admission policy that redirects non-urgent patients to alternative care pathways, such as telemedicine, during peak congestion. The ED is modeled as a two-class $M/M/c$ preemptive-priority queuing system, where high-acuity patients are prioritized and low-acuity patients are subject to state-dependent redirection. Analyzed via a level-dependent Quasi-Birth-Death (QBD) process, the model determines the optimal threshold by maximizing a long-run time-averaged objective function comprising redirection-affected revenue and costs associated with patient balking and system occupancy. Numerical analysis using national healthcare data reveals that optimal policies are highly context-dependent. While rural EDs generally optimize at lower redirection thresholds, urban EDs exhibit performance peaks at moderate thresholds. Results indicate that our optimal policy yields significant performance gains of up to $4.84\\%$ in rural settings and $5.90\\%$ in urban environments. This research provides a mathematically rigorous framework for balancing clinical priority with operational efficiency across diverse ED settings.",
"arxiv_id": "2601.10041",
"authors": [
"Sahba Baniasadi",
"Paul M. Griffin",
"Prakash Chakraborty"
],
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"cs.PF",
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],
"license": "http://creativecommons.org/licenses/by-nc-nd/4.0/",
"title": "Emergency Department Patient Flow Optimization with an Alternative Care Threshold Policy",
"url": "https://arxiv.org/abs/2601.10041",
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