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Process improvements in hospitals usually focus on a single department (eg. emergency department, operating theater, specialty clinic, etc). However, actions taken in one department inevitably affect the performance of other departments. Therefore, higher efficiency improvements can be obtained by considering the patient care process as one synergetic activity involving several departments and various sets of resources. In this research we propose an integrated approach for modeling the patient lifecycle for multiple departments. First we describe a patient flow from his/her entry into the hospital through a progressive care unit until the patient has fully recovered. We use process mapping methods to address value added activities and other necessary activities in the patient lifecycle. Then, a simulation model is developed in Simio using customized objects created in previous works. Those customized objects carry their own logic and behavior. For example, the Bed object includes logic for a patient recovering while using several hospital resources (nurses, therapist) in his/her hospital stay. Those objects were used to build several configurations of an integrated model with multiple departments. Data about patient arrival patterns, their health acuity, and procedure needs were obtained from a real hospital in order to test our approach. The procedures duration data (which were different for different levels of patient acuity and for different surgical and other procedures) were used to obtain service distribution using statistical analysis methods. Modular simulation objects and data distributions from real hospitals allowed us to build an integrated simulation model with several configurations of the process flow. Simulation experiments were performed on these models and performance recorded. The recommendation for implementations in the hospitals is also reported. |
