Inpatient admission management using multiple criteria decision-making methods

Emergency Department (ED) overcrowding is a public health issue associated with harmful effects simultaneously on patients and ED staff. Despite increased policies and efforts to manage this issue, it continues to rise in many EDs all over the world. ED overcrowding is not caused only by the high number of incoming patients and resources shortage, the most affecting factor leading to such problem is the inpatient boarding. In fact, the patient has to wait too long for an available hospital bed. This paper suggests a new approach to improve the inpatient flow using Multi-Criteria Decision Making (MCDM) methods. The aim is to make a rational choice of the appropriate department in the ward to which the inpatient can be assigned even if the department related to its pathology is already crowded. The Analytic Hierarchy Process (AHP) based Delphi is used to collect data. Then, the AHP method is used to determine the weights of criteria that have an impact on the assignment decision. Finally, Elimination and Choice Expressing Reality (ELECTRE) II, Technique for Order Preference by Similarity to Ideal Solution (TOPSIS), and Preference Ranking Organization METHod for Enrichment Evaluations (PROMETHEE) II are applied separately to rank the possible inpatient departments in ward in decreasing order of suitability to patient’s pathology. The provided approach is tested to the ED of Habib Bourguiba University hospital of Sfax, Tunisia where the aggregation of AHP-Delphi and TOPSIS is considered.