Using simulation to model and optimize acute care access in relation to hospital bed count and bed distribution

In Canada, acute care refers to the in-hospital treatment of a disease during its initial phases (typically measured in days). Determining how bed availability impacts patient access to care is of great interest to the British Columbia (BC) Ministry of Health Services and to the health service delivery industry worldwide. In this article we discuss a simulation queueing theory model with three input streams consisting of Emergency, Direct Elective and Direct Transfers, designed to examine the question of how bed counts impact access to acute care services inBC’s hospitals. We further develop an optimization algorithm to determine optimal bed allocations among hospital segments in order to minimize average patient wait time. The algorithm is demonstrated on an exemplar hospital. Journal of Simulation (2011) 5, 101–110. doi:10.1057/jos.2010.7; published online 14 May 2010