Patients admission process analysis in a large clinic by collective multivariate expertise methods

The article describes multivariate expertise methods applied to analyse the hospitalization process in a large clinic (N. N. Burdenko's Scientific Research Neurosurgery Institute of Health Ministry of Russia, as an example). More than 7000 operations are performed in the clinic every year and the end-to-end treatment process requires optimization. We consider different aspects of the treatment process: admission in the emergency department, multiple characteristics of stay in surgical wards and surgery unit itself. Our goal was to reduce the admission and surgery waiting times. Our approach was to formally organize collective expertise involving both the clinic staff and external specialists as the experts. The formal expertise procedure revealed some solutions that were difficult to foresee on the common sense basis. We use data provided by the hospital information system to evaluate the effect of various implemented proposals. The formal collective expertise reduced the waiting time significantly and becomes a solid foundation for further optimization decisions such as hiring additional nurse.