Physical Sciences and Mathematics Commons^™

Statistical Applications To The Management Of Intensive Care And Step-Down Units, Yawo Mamoua Kobara

Electronic Thesis and Dissertation Repository

This thesis proposes three contributing manuscripts related to patient flow management, server decision-making, and ventilation time in the intensive care and step-down units system.

First, a Markov decision process (MDP) model with a Monte Carlo simulation was performed to compare two patient flow policies: prioritizing premature step-down and prioritizing rejection of patients when the intensive care unit is congested. The optimal decisions were obtained under the two strategies. The simulation results based on these optimal decisions show that a premature step-down strategy contributes to higher congestion downstream. Counter-intuitively, premature step-down should be discouraged, and patient rejection or divergence actions should …