A Markov Chain Model for Transient Analysis of Handoff Process in Emergency Departments

Wenjun Zhu; Brian W. Patterson; Maureen Smith; Anne C. Rifleman; Pascale Carayon; Jingshan Li

doi:10.1109/LRA.2020.2996066

A Markov Chain Model for Transient Analysis of Handoff Process in Emergency Departments

Wenjun Zhu, Brian W. Patterson, Maureen Smith, Anne C. Rifleman, Pascale Carayon, Jingshan Li^*

^*Corresponding author for this work

Research output: Journal Publications and Reviews › RGC 21 - Publication in refereed journal › peer-review

6 Citations (Scopus)

Abstract

Transfer of care between multiple units or facilities is of significant importance for patient safety, care quality, and operation efficiency. Such transfers are often referred to as handoffs in hospitals, which need to be carried out timely, safely, and smoothly with accurate information. This article introduces a Markov chain model to study the transients of handoff process in hospital emergency departments. The handoff process is modeled by a stochastic process with unavailability of service, which characterizes the constraints in bed capacity, staff shortage, and coordination issues, etc. For systems only allowing one transfer request waiting, the transient performance is obtained through Laplace transform and its inverse transform. Such a result is then used as a building block to study the systems allowing multiple requests waiting through an iteration process, which can reduce the computation complexity substantially. Numerical studies show that such a method can provide estimates of transient performance in the handoff process with acceptable accuracy.

© 2020 IEEE. Personal use is permitted, but republication/redistribution requires IEEE permission.

Original language	English
Article number	9097425
Pages (from-to)	4360-4367
Number of pages	8
Journal	IEEE Robotics and Automation Letters
Volume	5
Issue number	3
Online published	20 May 2020
DOIs	https://doi.org/10.1109/LRA.2020.2996066
Publication status	Published - Jul 2020
Externally published	Yes

Funding

This research was supported in part by Grant CMMI-1536987 from the National Science Foundation, Grant 5R18HS026624 from the Agency for Healthcare Research and Quality (AHRQ), and Grant UL1TR000427 from the Clinical and Translational Science Award (CTSA) program, through the NIH National Center for Advancing Translational Sciences (NCATS). The work was also supported in part by the University of Wisconsin School of Medicine and Public Health through Wisconsin Partnership Program funding to the Wisconsin Institute for Healthcare Engineering and the Health Innovation Program.

Research Keywords

Emergency department
handoff process
Markov chain
transient analysis
waiting time

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title = "A Markov Chain Model for Transient Analysis of Handoff Process in Emergency Departments",

abstract = "Transfer of care between multiple units or facilities is of significant importance for patient safety, care quality, and operation efficiency. Such transfers are often referred to as handoffs in hospitals, which need to be carried out timely, safely, and smoothly with accurate information. This article introduces a Markov chain model to study the transients of handoff process in hospital emergency departments. The handoff process is modeled by a stochastic process with unavailability of service, which characterizes the constraints in bed capacity, staff shortage, and coordination issues, etc. For systems only allowing one transfer request waiting, the transient performance is obtained through Laplace transform and its inverse transform. Such a result is then used as a building block to study the systems allowing multiple requests waiting through an iteration process, which can reduce the computation complexity substantially. Numerical studies show that such a method can provide estimates of transient performance in the handoff process with acceptable accuracy. {\textcopyright} 2020 IEEE. Personal use is permitted, but republication/redistribution requires IEEE permission.",

keywords = "Emergency department, handoff process, Markov chain, transient analysis, waiting time",

author = "Wenjun Zhu and Patterson, {Brian W.} and Maureen Smith and Rifleman, {Anne C.} and Pascale Carayon and Jingshan Li",

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AU - Zhu, Wenjun

AU - Patterson, Brian W.

AU - Smith, Maureen

AU - Rifleman, Anne C.

AU - Carayon, Pascale

AU - Li, Jingshan

PY - 2020/7

Y1 - 2020/7

N2 - Transfer of care between multiple units or facilities is of significant importance for patient safety, care quality, and operation efficiency. Such transfers are often referred to as handoffs in hospitals, which need to be carried out timely, safely, and smoothly with accurate information. This article introduces a Markov chain model to study the transients of handoff process in hospital emergency departments. The handoff process is modeled by a stochastic process with unavailability of service, which characterizes the constraints in bed capacity, staff shortage, and coordination issues, etc. For systems only allowing one transfer request waiting, the transient performance is obtained through Laplace transform and its inverse transform. Such a result is then used as a building block to study the systems allowing multiple requests waiting through an iteration process, which can reduce the computation complexity substantially. Numerical studies show that such a method can provide estimates of transient performance in the handoff process with acceptable accuracy. © 2020 IEEE. Personal use is permitted, but republication/redistribution requires IEEE permission.

AB - Transfer of care between multiple units or facilities is of significant importance for patient safety, care quality, and operation efficiency. Such transfers are often referred to as handoffs in hospitals, which need to be carried out timely, safely, and smoothly with accurate information. This article introduces a Markov chain model to study the transients of handoff process in hospital emergency departments. The handoff process is modeled by a stochastic process with unavailability of service, which characterizes the constraints in bed capacity, staff shortage, and coordination issues, etc. For systems only allowing one transfer request waiting, the transient performance is obtained through Laplace transform and its inverse transform. Such a result is then used as a building block to study the systems allowing multiple requests waiting through an iteration process, which can reduce the computation complexity substantially. Numerical studies show that such a method can provide estimates of transient performance in the handoff process with acceptable accuracy. © 2020 IEEE. Personal use is permitted, but republication/redistribution requires IEEE permission.

KW - Emergency department

KW - handoff process

KW - Markov chain

KW - transient analysis

KW - waiting time

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EP - 4367

JO - IEEE Robotics and Automation Letters

JF - IEEE Robotics and Automation Letters

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ER -

A Markov Chain Model for Transient Analysis of Handoff Process in Emergency Departments

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Research Keywords

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