Sensitivity Analysis in Bed Capacity Studies including the Medical Staff's Decision Making

This paper deals with capacity planning studies in intensive care units (ICU). Our aim is to provide a framework in which the discharge policy from an ICU can be modelled and included in a simulation model. This is a very unique contribution of this research. We highlight the influence of the assumed policy in the ICU quality of service. A high quality of service means a low percentage of rejected patients and a length of stay in the ICU as long as necessary for the patient recovery. We introduce a parameterized set of rules to mathematically model the discharging decisions made by the physicians of an ICU. Then we present a sensitivity study carried out for the ICU of the Hospital of Navarra in Spain. The set of discharge policies is represented in the space of the performance measures to distinguish efficient from no efficient policies. Finally, the sensitivity analysis is extended, firstly, by considering variation in the number of beds and, then, by varying the patient arrival ratio.