Establishing generic problem structures and repeatable solution approaches for healthcare delivery problems

Designing systems that are viable over the long term (i.e. sustainable) is a problem faced in many industries. Inventory systems which receive more products than they ship run out of space. Call centres receiving calls faster than they end calls see waiting times grow unbounded. Healthcare practices that accept more new patients than they can actively treat will experience congestion and/or overtime. Complicating these systems is uncertainty, thus setting capacity equal to demand is insufficient and results in the need to incorporate idle capacity as a buffer. This buffer is crucial for sustainability and performance but is often set low in order to minimize "unused" capacity. Among others, determining the size of this buffer and designing clever ways (e.g. pooling) to get by with less are substantial challenges to designing sustainable systems. This research program will focus on designing sustainable healthcare delivery systems. Specifically we will solve patient flow, congestion and capacity planning problems that are common in many hospitals. To broaden the impact of operations research on these problems, we will develop comprehensive problem definitions and structures such that the solutions methodologies are applicable in multiple settings. From studying successes in other service industries, we believe that a queueing based approach is promising for developing such methodologies. Queueing theory is particularly apt at characterizing and designing systems for general settings. Such results typically span application areas and can provide general insights and outline specific courses of action. This has been seen in the telecommunications industry and more recently in the study and design of call centres. Despite the highly stochastic nature of healthcare and the growing need, the use of queueing theory to support the Canadian healthcare system is not commonplace. The service characteristics of healthcare are unique and will require the development of new queueing models and methodology. From this research, general insights and recommendations for specific interventions will contribute to the design of a sustainable healthcare system.