**So the Operational research problem is to be formulated as follows:**

How to distribute or divide the given Budget (or Budget Index Value) into Ri (i= 1,……..,n), such that PFIi ≥ PFIa, for all i; and CEIi ≥ CEIa, for all i This then is the prime task of a Hospital administrator!

### **Summarizing:**

44 Biomedical Science, Engineering and Technology

Hence, the higher the value of ICU performance index, the better is the performance of the ICU. If now a patient dies, as a result of the PHII becoming negative (i.e slipping from (say)

> *PHII* ⎛ ⎞ <sup>−</sup> = = <sup>−</sup> ⎜ ⎟ ⎝ ⎠

As a result, ΣPHII (in equation 3) will decrease, and the overall value of ICU performance

**Cost-Effective Index:** Now, let us consider that (i) we have one physician and five nurses for a 10 bed CCU, based on the probability-of-occurrence of two patients having lifethreatening events being say 0.2 (or 20%), and that (ii) for this human resource/staffing, the

If we increase the staffing, the ICU performance index value could go upto 50 or so, at the expense of more salary cost. So now we can come up with another indicator namely, **Cost-**

> salary Total units)-salary(in index Performanc index e

So if an ICU has one physician with a monthly salary of 20,000 (i.e. 2 salary-units) and four

index Resource units)-salary of (in terms

Now, let us assume that we raise the **PFI** (ICU) to (say) 60 by augmenting the nursing staff, so as to have six nurses (Ri = 3 units) and 1.5 full-time equivalent physician-on-duty (Ri = 3

So while the PFI of ICU has gone up from 40 to 50, the CEI of ICU has gone down from 10 to

**Strategy of Operation:** Our strategy would be to operate this Performance-Resource system, in such a way that we can determine the resource index Ri for which we can obtain acceptable values of both PFI and CEI. In a way, figure (31) could represent this balance

Salary-units Index or Resource Index,R [ (2 2.0)]

50 8.3 (3 3) *<sup>i</sup>*

*<sup>R</sup>* == = <sup>+</sup>

<sup>=</sup> = +

wherein, say, a salary of 1000=0.1 unit, 10,000=1 unit, 20,000=2 units, and so on.

Performanc index e <sup>=</sup>

nurses each with a total monthly salary of 5,000 (i.e. total of 2.0 salary-units), then

*PFI CEI (ICU)* 

between PFI & CEI, in order to determine optimal Resource Index or resource [15].

Performance index (of40) ICU

*PHII ICU* <sup>∑</sup> <sup>=</sup> (3)

10 30 <sup>100</sup> <sup>67</sup> <sup>30</sup>
