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Modelling hospital operations: insight from using data from paper registries in the obstetrics ward at a hospital in Addis Ababa, Ethiopia
  1. Benjamin Bigelow1,
  2. Dawit N Desalegn2,3,
  3. Joshua A Salomon4,
  4. Stéphane Verguet1
  1. 1Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
  2. 2Global Public Health and Primary Care, University of Bergen, Bergen, Norway
  3. 3Center for Medical Ethics and Priority Setting, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
  4. 4Medicine, Stanford University School of Medicine, Palo Alto, California, USA
  1. Correspondence to Professor Stéphane Verguet; verguet{at}hsph.harvard.edu

Abstract

In the Ethiopian health system, operations management techniques have been underutilised. Although previous research has outlined limitations of paper-based patient records, few studies have examined their potential utility for improving management of hospital operations. In this paper, we used data collected from paper registries in an Ethiopian obstetrics ward at Addis Ababa’s Tikur Anbessa Specialized Hospital, Ethiopia’s largest university hospital, to model the ward’s operations. First, we attempted to identify predictors of lengthy stays and readmissions among women giving birth: few predictors were deemed significant. Second, time series methods for demand forecasting were applied to the data and evaluated with several error metrics, and these forecasts were improvements over baseline methods. We conclude with recommendations on how the obstetrics ward could incorporate our modelling approaches into their daily operations.

  • health systems
  • hospital-based study
  • maternal health
  • health services research

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/bmjgh-2018-001281

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    Footnotes

    • Handling editor Seye Abimbola

    • Contributors BB and SV conceptualised the paper, performed the data analysis and led the manuscript writing. DND assisted with data collection and interpretation. JAS contributed to the design and interpretation of the data analysis. All the authors critically revised the content of the paper, approved the final version and agree to be accountable for all aspects of the work.

    • Competing interests BB is employed by Hospital IQ (Boston, Massachusetts), a US healthcare software company. The author has received stock options from Hospital IQ and CareJourney (Arlington, Virginia). The majority of research, data analysis and manuscript preparation occurred while the author was in graduate school and prior to the author’s employment at Hospital IQ.

    • Patient consent for publication Not required.

    • Ethics approval The institutional review boards for Addis Ababa University College of Health Sciences and Harvard T H Chan School of Public Health approved this study (protocol number: IRB16-0993). All data collection and analyses complied with the regulations established by both institutions.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement No additional data are available.