Modeling and Analysis of Patient Transitions in Community Hospitals: A Systems Approach

A patient's stay at a hospital may encompass various departments or units. Since many critical and complex problems occur at the interfaces of healthcare delivery systems, safe and efficient transitions between the departments within a hospital has significant importance. This paper presents a Markov chain-based model to study patient transitions between emergency department, intensive or critical care unit, and hospital ward in small and medium-sized community hospitals. To make the analytical study tractable, an iteration method is introduced to approximate the system performance during transitions, including direct transferring probabilities without waiting, average patient occupancy in each department, and average patient length of stay. In addition, system properties, such as monotonicity and sensitivity, are analyzed. It is shown that such a method has a high accuracy in performance estimation and can be used to study and improve patient transitions in small or medium-sized hospitals.