Prediction-Driven Surge Planning with Application in the Emergency Department

ABSTRACT: Determining emergency department (ED) nurse staffing decisions to balance the quality of service and staffing cost can be extremely challenging, especially when there is a high level of uncertainty in patient-demand. Increasing data availability and continuing advancements in predictive analytics provide an opportunity to mitigate demand uncertainty by utilizing demand forecasts. In this work, we study a two-stage prediction- driven staffing framework where the prediction models are integrated with the base (made weeks in advance) and surge (made nearly real-time) staffing decisions in the ED. We quantify the benefit of having the ability to use the more expensive surge staffing and identify the importance of balancing demand uncertainty versus demand stochasticity. We also propose a near-optimal two-stage staffing policy that is straightforward to interpret and implement. Lastly, we develop a unified framework that combines parameter estimation, real- time demand forecasts, and capacity sizing in the ED. High-fidelity simulation experiments for the ED demonstrate that the proposed framework can reduce annual staffing costs by 11%–16% ($2 M–$3 M) while guaranteeing timely access to care. Joint work with Yue Hu and Jing Dong.

Bio: Carri W. Chan is the John A. Howard Professor of Business and the Faculty Director of the Healthcare and Pharmaceutical Management Program at Columbia Business School. Her research is in the area of healthcare operations management. Her primary focus is in data-driven modeling of complex stochastic systems, efficient algorithmic design for queuing systems, dynamic control of stochastic processing systems, and econometric analysis of healthcare systems. Her research combines empirical and stochastic modeling to develop evidence-based approaches to improve patient flow through hospitals. She has worked with clinicians and administrators in numerous hospital systems including Northern California Kaiser Permanente, New York Presbyterian, and Montefiore Medical Center. She is the recipient of a 2014 NSF CAREER award, the 2016 POMS Wickham Skinner Early Career Award, and the 2019 MSOM Young Scholar Prize. She currently serves as a co-Department Editor for the Healthcare Management Department at Management Science. She received her BS in electrical engineering from MIT and MS and Ph.D. in electrical engineering from Stanford University.