Designing Observation Units for Heart Failure Patients: Capacity and Patient Flow Considerations

In light of reported benefits, including reduced unnecessary hospitalization and postdischarge events, an increasing number of hospitals are introducing observation units for heart failure patients. To this end, the hospital administrators need to determine the optimal size of the observation unit as well as the admission and discharge policies that would maximize efficiency of the unit under a given capacity. We propose a two-phase methodological framework for designing an observation unit for heart failure patients. In the first phase, by studying various patient volumes and arrival patterns based on a data set from a large secondary hospital, we investigate the optimal number of beds to be installed in an observation unit by means of different analytical models. In the second phase, we study the possible admission and discharge policies for this observation unit with a prespecified capacity. We assess each policy under various quality-of-care and cost criteria, including the probability of postdischarge events, the likelihood of hospitalization, the total cost and the cost–gain ratio. We provide managerial insights for hospital administrators through extensive numerical experiments.