Improved intrahospital transport time via proximity-based staff assignments.

Abstract

Intrahospital patient transport is pivotal in enabling hospital operations and facilitating safe and efficient patient movement. However, transport delays are common in hospitals, signaling a need for improvement. This study develops, implements, and evaluates a proximity-based transporter-to-request assignment system aimed at improving transport service system efficiency. In this observational study, we used discrete-event simulation to design and optimize an enhancement to an electronic medical record's original first-in, first-out transporter-to-request assignment system, and we implemented it at a quaternary care academic medical center. Our enhancement prioritizes requests based on the proximity of available transporters within pre-specified areas. We compared transport request completion time (primary outcome) and the percentage of transports exceeding 45 minutes (secondary outcome) during control (01/2021-02/2022) and intervention (02/2022-03/2023) periods and estimated their differences using multivariate generalized linear models to adjust for confounding factors including variable workforce levels and workload. A total of 136 414 transport requests were included in the study. The intervention was associated with an adjusted 5.0% (95% confidence interval 1.8%-8.5%) reduction in completion times and a 16.0% (7.4%-23.9%) relative reduction in the percentage of trips exceeding the 45-minute completion time target. The intervention's improvements stem from reductions in unnecessary travel time between transport requests, common to first-in first-out assignment systems. The intervention was designed to be natively integrated into existing electronic health record systems, reducing barriers to real-world adoption. Implementing a proximity-based assignment system designed based on simulation-optimization modeling improved intrahospital patient transport efficiency without requiring additional staff.