Modelling hospital operations: insight from using data from paper registries in the obstetrics ward at a hospital in Addis Ababa, Ethiopia

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.

Keywords: health services research; health systems; hospital-based study; maternal health.

Figure 1

Daily admissions to the obstetrics and gynaecology ward at Tikur Anbessa Specialized Hospital over 2015–2016, showing both raw data and a smoothed 7-day moving average.

Figure 2

Average number of admissions by day of the week in the obstetrics and gynaecology ward at Tikur Anbessa Specialized Hospital over 2015–2016, with 95% CIs.