Smart mathematics is key to better and cheaper healthcare

HEALTHCARE organisations face huge challenges during the upcoming years: the constant cost increases must be halted, while at the same time patients are becoming more and more demanding, and hospitals nationwide still cope with some 2000 avoidable deaths each year. Simultaneously improving efficiency and quality of care would seem to be a contradiction in terms. Yet Nikky Kortbeek shows in his thesis, along a number of case studies, that this is absolutely doable. The key is developing and applying mathematical models.

Mr Kortbeek did his PhD research in Prof Richard Boucherie’s Stochastic Operations Research Group, which is part of the CTIT research institute at the University of Twente. The thesis, “Quality-Driven Efficiency in Healthcare”, is based on research for healthcare institutions took place under the auspices of the Center for Health Operations Improvement Research (CHOIR), which is now working together with many medical centres in the Netherlands.

Uncertain versus unpredictable

It sounds plausible that a nursing ward cannot be prepared for every scenario possible: the number of patients arriving during a certain day is unknown, some recover more quickly than others, and complications may occur. But this does not mean that it is impossible to plan ahead.

“Variability is not the same as unpredictability. It is the goal of our research field, stochastic operations research, to help problem owners make the best possible decisions in complex and uncertain environments,” , Mr Kortbeek explained.

Politically charged

Mathematical models also facilitate decision-making processes in hospitals, he said. As healthcare environments are often politically charged, experimenting with a new approach in practice straight away is a high-risk strategy.

Mathematical models have a quantitative predictive value. This makes healthcare professionals more ready to acknowledge and understand the need for the proposed measures: they provide insight in why a new approach works better.

Flexible staffing

Mr Kortbeek’s thesis describes a number of cases where he and his fellow researchers supported hospitals to organize processes in the healthcare chain as a whole so as to make better use of scarce resources such as beds, operating theatres and staff. For instance, they can predict bed occupancies on an hourly level if they take relevant information on operating theatre schedules into account. They also propose flexible nurse staffing strategies.

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