Real option analysis of flexibility in a hospital emergency department expansion project : a systems approach

Abstract

Hospital Emergency Departments across the United States have been experiencing demand in excess of their capacity to treat patients for the last two decades. This research considers a hypothetical case inspired by a hospital in the Greater Boston undergoing an ED expansion to meet existing and projected demand. A traditional infrastructure expansion project approach to plan, design and immediately build for expected demand 10 to 15 years into the future is compared to a flexible design able to meet short term demands and then adapt to future demand realization. It is the overall objective of this research to identify, characterize and quantify the parameters that should be considered in ED expansion projects and provide useful modeling techniques to drive investment decisions that best allow hospital administrators to provide expected level of service to their patient population.