Managing a bone marrow transplant centre to maximise patients' health benefits

Abstract

We study a Bone Marrow Transplant (BMT) Centre whose objective is to maximise the expected health benefits of the admitted patients. The arrival of patients is a renewal process with generally distributed inter-arrival times, and the length of stay in a transplant room is a generally distributed random variable. Arriving patients are immediately admitted into a transplant room if available; otherwise, they would be added to a finite waiting list called patient reserve. When a transplant room becomes available, a member of the patient reserve is selected for admission. Patients who arrive when all transplant rooms are occupied and the patient reserve is full are referred to other BMT Centres. Because the patient reserve members' health will continue to deteriorate while waiting for a transplant room, our research results illustrate the optimal trade-offs among the number of transplant rooms, the number of spots in the patient reserve, and the expected health benefits of the admitted patients. Our experience with a leading BMT Centre supports the notion that an understanding of these optimal trade-offs is crucial for managers of BMT Centres.

Keywords:

• Queuing theory
• optimisation
• process improvement
• quality-adjusted life years
• service design

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, BL, upon reasonable request.

Additional information

Funding

This work was supported by the Ningbo China Institute for Supply Chain Innovation [P2020002].

Notes on contributors

Bo Li

Bo Li is an Associate Professor at Ningbo China Institute for Supply Chain Innovation (NISCI) and a research affiliate at MIT Centre for Transportation and Logistics. He was a visiting scholar at MIT in 2017 and 2020. He oversees both the MIT-Ningbo Supply Chain Management Program and the MIT SCALE Nottingham Ningbo MSc Programme in Supply Chain Management. Having previously worked at Schlumberger and KLA-Tencor, Dr Li's research agenda centres on managing supply chain risks in areas such as retail, healthcare, chemicals, and cloud services. He has published in premier academic journals such as Production and Operations Management, European Journal of Operational Research, and Naval Research Logistics. He was the chief organiser of the 11th CSAMSE annual conference in 2018. Dr Li hold a PhD degree in Business Administration (Information and Operations Management) from Texas A&M University, master's degrees from Massachusetts Institute of Technology and Nanyang Technological University, and a bachelor's degree from Shanghai Jiao Tong University.

Antonio Arreola-Risa

Antonio Arreola-Risa is an Associate Professor at Mays Business School, Texas A&M University. He previously worked as a production and inventory control analyst, and later he taught at Tecnológico de Monterrey and the University of Washington. His primary research, teaching and consulting interests are on production-inventory systems with emphasis in supply chain management and Enterprise Resource Planning, as well as on service operations with emphasis in health care delivery. He has taught undergraduate, masters and doctoral courses. He has also lectured in executive education programs and consulted for numerous companies in the U.S. and abroad. He is on the CHI St. Joseph Health Board of Directors.

Dr Arreola-Risa is a member of the Decision Sciences Institute, the Institute of Industrial Engineers, the Institute for Operations Research and the Management Sciences, and the Production and Operations Management Society. His research has been published in the professional journals Computers & Operations Research, Decision Sciences, European Journal of Operational Research, IIE Transactions, Management Science, Naval Research Logistics, and Production and Operations Management.