A Simulation Model to Evaluate the Patient Flow in an Intensive Care Unit under Different Levels of Specialization

Intensive care units are complicated hospital departments in that they have both urgent and elective patients with a variety of specialty needs that cannot be easily treated elsewhere. Their design involves important operations strategy decisions, such as whether there are general facilities serving all patients or several specialized units for certain patient needs, or something in between. They also involve bed capacity decisions for the aggregate and potentially specialized units. This paper presents a simulation model which is used to assess trade-offs in these operational design issues with respect to three performance measures (rejection rate, rescheduling rate, and bed occupancy rate), using data and design options for the Academic Medical Center (AMC), one of two locations forming the Amsterdam University Medical Centers (UMC).