YOĞUN BAKIM ÜNİTELERİNDE KAPASİTE YÖNETİMİ: ARA SERVİS OLUŞTURMA VE BİR UYGULAMA

Yıl 2024, Cilt: 6 Sayı: 2, 181 - 197

Alkan Durmuş

Öz

Sağlık hizmeti sunum sistemlerinin tasarımı, verimli hasta kapasitesi ve akış yönetimi sağlamak için kritik öneme sahiptir. Kötü tasarlanmış sistemler darboğazlara, gecikmelere ve hasta sonuçlarını ve deneyimlerini olumsuz etkileyebilecek diğer verimsizliklere yol açabilir. Ekonomik açıdan bakıldığında, yoğun bakım ünitesi kullanımının maksimize edilmesi, hastane yöneticileri için bir hedef olarak görülebilir. Bunun nedeni, yoğun bakım ünitesinin tipik olarak bir hastanenin en pahalı ve kaynak yoğun alanlarından biri olmasıdır ve yoğun bakım ünitesinin kullanımını en üst düzeye çıkarmak, bu kaynakların kullanımını optimize etmeye yardımcı olmasıdır.
Yoğun bakım hizmetlerine olan talebin artışı, sağlık kurumlarının işleyişinde ve kapasitesinde sorunlara yol açmaktadır. Sağlık kuruluşlarının bu zorluklara karşı verdiği yetersiz yanıt, doğrudan olumsuz hasta sonuçlarına ve maliyet artışlarına neden olabilir. Bu çalışmada, yoğun bakım hasta bekleme sürelerini ve kapasite yönetimini etkileyen sorunlar incelenecek ve bunları iyileştirmek için stratejiler ve politikalar önerilecektir. Araştırma amacına uygun olarak öncelikle, yoğun bakım ünitesindeki hasta kabul ve taburculuk aşamalarındaki bekleme süreleri incelenerek sistemdeki kısıtlar belirlenecektir. Daha sonra sorunların çözümüne ilişkin olarak, YBÜ'nün kapasite ihtiyacı ve ara servisin ne büyüklükte olması gerektiği ve YBÜ ve ara servis hasta akışına ilişkin bir simülasyon modeli önerisi sunulacaktır. Çalışma, hastane planlamacılarına ve doktorlara, sınırlı YBÜ yatak kaynaklarını daha etkin bir şekilde tahsis etmek için alternatif çözümler sunmayı amaçlamaktadır. Elde edilen bulgular, yoğun bakım ve ara servislerin boyutlandırılmasıyla ilgili karar verme sürecinde hastanelere farklı bir perspektif sunmaktadır. Bu, daha etkili kaynak yönetimi ve kapasite planlaması için yeni yaklaşımların düşünülmesini gerektirebilir. Hastanelerde YBÜ'lerin hasta akışındaki kritik durumu ve süreçlerdeki kısıtları göz önüne alındığında, kapasite yönetiminde simülasyon modellerinden yararlanmanın, hastane yönetimlerine kaynakların sunumunu değerlendirmek için alternatif modeller sunabileceği düşünülmektedir.

Anahtar Kelimeler

Yoğun Bakım Ünitesi, Ara Bakım Üniteleri, Hasta Akışı, Kapasite Yönetimi, Simülasyon

CAPACITY MANAGEMENT IN INTENSIVE CARE UNITS: CREATING INTERMEDIATE SERVICES AND AN APPLICATION

Öz

The design of healthcare service delivery systems is of critical importance in ensuring efficient patient capacity and flow management. Poorly designed systems can lead to bottlenecks, delays, and other inefficiencies that can have negative impacts on patient outcomes and experiences. From an economic perspective, maximizing the utilization of intensive care units can be seen as a goal for hospital administrators. This is because the intensive care unit is typically one of the most expensive and resource-intensive areas of a hospital, and maximizing the utilization of the intensive care unit helps in optimizing the use of resources. The increasing demand for intensive care services is causing flow and capacity issues for healthcare institutions. The weak response of healthcare institutions to these challenges can directly result in adverse patient outcomes and increased costs. In this study, the issues that affect intensive care patient waiting times and capacity management will be examined, and strategies and policies will be proposed to improve them. In line with the research objective, firstly, the waiting times during patient admission and discharge stages in the intensive care unit will be examined to identify constraints in the system. Subsequently, regarding the resolution of the issues, a simulation model proposal will be presented concerning the capacity needs of the intensive care unit, the appropriate size of the intermediate service, and the patient flow between the intensive care unit and the intermediate service. The study aims to provide hospital planners and doctors with alternative solutions to allocate limited intensive care unit bed resources more effectively. The findings offer a different perspective to hospitals in the decision-making process regarding the sizing of intensive care and intermediate wards. This may require considering new approaches for more effective resource management and capacity planning. Considering the critical nature of patient flow in intensive care units and the constraints in the processes within hospitals, utilizing simulation models in capacity management is believed to capable of providing hospital administrations with alternative models to assess resource allocation.

Anahtar Kelimeler

Intensive Care Unit, Intermediate Care Units, Patient Flow, Capacity Management, Simulation

Kaynakça

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