Western University study says math is the answer to ‘hallway medicine’

David Stanford says the method would help doctors decide who to see next. Western University/Handout

A new study out of Western University may have found a solution to “hallway medicine.”

The study, done by David Stanford, a professor in Western’s department of statistical and actuarial sciences, his former PhD students Na Li and Azaz Sharif and two authors, says math and stats hold the key to easing the epidemic that plagues hospitals across the country.

According to a report released by the Canadian Institute of Health Information that focused on wait times in 2012, emergency rooms aim to see 90 per cent of patients who fall in the “urgent” category within 30 minutes of arrival. That is their clinical target.

Based on their dataset from 2012 and 2013, just over nine per cent of “urgent” patients were seen within that timeframe, said Stanford.

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“The current targets are unachievable not only because of limited resources, funds or personnel but because the way we’re calculating physician hours needed is not realistic in terms of patient flow and the varying levels of trauma that come to Canadian emergency rooms,” he said.

The study points out that certain key performance indicators specify delay targets and per cent compliance levels, but don’t offer any “best” solution.

It also found that current emergency room staffing policies, which do a simple accounting-style estimation of expected patient volume, are inadequate because they don’t account for variables –leading to understaffing.

Their solution? A method that tracks how patients are doing based on their current condition, which will allow them to collect “priority points” while they wait.

“This approach to minimizing the expected number of patients that are forced to wait beyond their targeted times can be implemented fairly easily,” Stanford said.

“For instance, you need to try to get the patients to be seen in a timely fashion, based upon how sick they are in that time,” he said.

Another field just needs to be added to the emergency department inpatient dashboards, which Stanford says will help doctors decide who to see next, subject of course to medical decision-making.

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“There’s no shortage of talented people, such as industrial engineers, who can assist the doctors and decision-maker,” Stanford said.

“But with the current model that essentially just plays the averages — like an accounting-based model — doesn’t take advantage of these extremely useful people. Instead, it caters to government pumping more money in, and hoping something changes.”

He added hospital wards are almost always full, keeping patients from being transferred out of emergency departments and hallways. This method, according to Stanford, can help ease those issues.

The study will be published by the European Journal of Operational Research.

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