Development and evaluation of token-based decentralized decision making system in healthcare facilities

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K19386
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 58010:Medical management and medical sociology-related
• Research Institution: The Tazuke Kofukai (2021); Kyoto University (2019-2020)
• Principal Investigator: HIRAGI Shusuke 公益財団法人田附興風会, 医学研究所 保健・健康研究部, 研究主幹 (60781523)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: トークンエコノミー法 / 病院管理 / 意思決定 / ベッドコントロール / 経営学

Outline of Final Research Achievements

We proposed token-economy based bed allocation system which regarded nursing efforts as transaction between physicians and nurses. We also evaluated aforementioned system with computer simulation to examine its behavior, as well as with active nurse managers to hear their impressions about the system. Our result showed the behavior of the system, shown by allocation of patients, was not so different from conventional method. Nurse managers responded that employee satisfaction might improve and the timeliness of decision could be achieved, but they were anxious about evoking managerial rivalry. Summarizing these results, we concluded the method could be beneficial for hospital management through achieving optimized resource allocation.

Free Research Field

病院管理学

Academic Significance and Societal Importance of the Research Achievements

これまで病院経営に関する意思決定は中央集権的に資源配分を行うものが多かったが、経営が複雑化する中で管理者に集中する情報が増え、必ずしも効率的な配分につながっていなかった。本研究では代用貨幣を通じて院内各部門が直接資源をやり取りすることを考案し、ベッドコントロールという個別課題でその有用性を検討した結果、迅速な意思決定や従業員満足の向上につながることが示唆された。これにより、病院経営の新たなツールを提案することができた。