Title
A Markovian queueing model for ambulance offload delays.
Abstract
Ambulance offload delays are a growing concern for health care providers in many countries. Offload delays occur when ambulance paramedics arriving at a hospital Emergency Department (ED) cannot transfer patient care to staff in the ED immediately. This is typically caused by overcrowding in the ED. Using queueing theory, we model the interface between a regional Emergency Medical Services (EMS) provider and multiple EDs that serve both ambulance and walk-in patients. We introduce Markov chain models for the system and solve for the steady state probability distributions of queue lengths and waiting times using matrix-analytic methods. We develop several algorithms for computing performance measures for the system, particularly the offload delays for ambulance patients. Using these algorithms, we analyze several three-hospital systems and assess the impact of system resources on offload delays. In addition, simulation is used to validate model assumptions. (C) 2012 Elsevier B.V. All rights reserved.
Year
DOI
Venue
2013
10.1016/j.ejor.2012.11.030
European Journal of Operational Research
Keywords
Field
DocType
Queueing theory,Matrix-analytic method,Ambulance offload delay,Priority queues
Markov process,Emergency department,Queue,Overcrowding,Priority queue,Queueing theory,Emergency medical services,Matrix analytic method,Operations management,Mathematics
Journal
Volume
Issue
ISSN
226
3
0377-2217
Citations 
PageRank 
References 
8
0.61
5
Authors
3
Name
Order
Citations
PageRank
Eman Almehdawe181.62
Beth Jewkes280.94
Qi-Ming He323034.21