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Towards Prompt and Definitive Care of Trauma Patients

Dr. Pratik J. Parikh
Professor & Chair of IE 
University of Louisville
Friday, September 17, 2021 
2:45-3:45pm (virtual only)


Trauma injury (due to motor vehicle crash, falls, and gunshots) is the #1 cause of death among US citizens <45 years old and #3 overall across all ages, with an economic burden of $671 billion annually. Recent literature suggests that geographical maldistribution of Trauma Centers (TCs), and the resultant increase of the access time to the nearest TC, could impact patient safety and increase disability or mortality.

In this talk we will discuss our collaboration with the Trauma Division at a Midwestern US state. Starting with the typical process of how care is provided to a trauma victim at the scene, we will briefly discuss key strategic and operational decisions, and their impact on patient safety and costs. One of the strategic decisions is the number and location of TCs to improve patient safety. To address this decision problem, we introduce the Trauma Center Location Problem (TCLP) and present an optimization model with the objective to minimize mistriages (a surrogate measure for patient safety). Mistriages occur because of a mismatch in the injury severity of a trauma patient and the capabilities of the destination hospital. We estimate mistriages using a notional tasking algorithm that mimics the EMS decision making process at the injury site. Based on 2012 data from the state of Ohio, we observe that the near-optimal network derived from our approach resulted in over 31.5% reduction in the overall objective with only 1 additional TC needed in the state; redistribution of the existing 21 TCs led to 30.4% reduction.

Our proposed approach can help state trauma decision makers in not only benchmarking their current network of TCs, but also optimizing it (either as a greenfield or redistribution problem). They can also conduct ‘what-if’ analysis by fixing certain TCs in their current locations and finding the locations of other TCs in the state. This latter approach can be of particular interest to those states where a mass reallocation of TCs is not possible; instead, they are seeking to gradually move towards an optimal network over a period of time. The approach can also be used to evaluate the viability of a proposal (from a local health system) to upgrade an NTC to a TC or downgrade an existing TC to an NTC in a specific region of the state. At the end of the talk, extensions of this model in terms of a 3-level trauma network design and inclusion of patient choice at the scene will also be discussed.



Dr. Pratik J. Parikh is a Professor and Chair of the Department of Industrial Engineering at the University of Louisville. He holds a Ph.D. in Industrial and Systems Engineering from Virginia Tech (2006). Dr. Parikh’s research in data analytics and optimization with applications in supply chain, retail, and healthcare has been supported by grants from the National Science Foundation, the Veterans Affairs, state of OH, and industry. He has served on various boards at the Institute of Industrial and Systems Engineers (IISE) and the Institute for Operations Research and Management Sciences (INFORMS). He currently serves as the Technical VP for the Technical Operations Board at IISE. For his contributions towards research, teaching, and service, he was honored with the IISE-LSC Division Teaching Award, IISE Global Outstanding Faculty Advisor Award, INFORMS Volunteer Service Award, several university awards, and the Dayton Forty Under 40 Award. Dr. Parikh’s students have received multiple Best Track Paper awards and national scholarships for their outstanding research accomplishments.