Validation of a Model Using Flexsim HC, ProModel simulation to improve the Flow of Patient through a medical HC Facility

Abdualaziz E AlqahtaniKFT221University of Tennessee at ChattanoogaIndustrial Engineering project Nov 30th, 2015

The Content Introduction Background Deliverables Project overview Assumptions Patient flow Process overview Data Analysis Simulation data Simulation Simulation Layout

The Content Challenges Results Best scenario Results Comparison Flexsim Flexsim results Scenarios Conclusion Future work

Introduction

the US healthcare system had shortcomings due to the growing complexity of medical practice by a poor organization healthcare delivery system; in fact the aging population was another factor that affected the deliverables of healthcare practices too. Nowadays, Healthcare facilities are experiencing continuously increasing pressure to perform effectively and efficiently due to the accessibility of new medical devices, the number of patients, and more importantly the competition between healthcare providers.

Background 2011 Capstone Project

Patient Process Time by Service Steps Recommended 25 Minute Scheduling Intervals

2012 Capstone Project Recently Expanded Facility Refine Provider Service Times Refine Service Step Times Facility Assessment of Expanded Facility Analysis of Employees Activities

2015 ???

Background 2015 project

Study the effect of increasing and/or decreasing the Exam Rooms in the facility

Nurse utilization Analyzing the average time in system in

accordance with processing time Analyzing the average time in system in

accordance with number of patients Manipulate the arrival time Validate Promodel simulation via Flexsim HC

Deliverables

Simulation to measure the effect of multiple scenarios for patient, resource and flow changes.

Nurse activities. Reduce waiting time Down size the number of Exam Room and

compare the effect in the overall processing time.

Project Overview The understanding of the operational overview would

help in designing the simulation model. The operational overview explains the movement of patients from entering the system till they exit

Assumptions Process starts at t=0 Patient arrive every 15 min No walk-ins Patients are processed oldest first The data collected from the time study is a valid

representation of the system There is down time for one or multiple exam

rooms Resources have no downtime The travel time is negligible Check out time is negligible The distribution used is Normal

Patient Flow

Process Overview  

# Providers 6 AIM providers 6 AIM providers 6 AIM providers

#Nurses 9 Nurses 9 Nurses 8 Nurses

Lab 1 1 1

# Triage Room 1 2 2

# Exam Rooms 6 18 13

2011 2012 2015

Increasing Exam Rooms = increasing waiting time

Data Analysis

Simulation Data

Simulation the purpose simulation programs is find the areas that

can be improved through multiple scenarios. These scenarios are involving the staff utilization, Exam room utilization, scheduling and number of patients.

Two computer programs have been used. The purpose is to validate the results. The programs used are:

ProModel FlexSim

Expectations: Reduce the waiting time Eliminate the accumulation of patients Nurse Utilization. And, Exam Room utilization

Promodel Layout

FlexSim Layout

Challenges There are few challenges using FlexSim Health Care:

lack of overview global process simulation possibility to measure specific activity performance

(e.g the time spent waiting for doctor) The designed model runs on number of hours,

therefore, running number of patents was never an option.

Scenario In this scenario

6 scenarios run for 4 hours and 16 Patients, 50 replicate Arrival Rate 15-30 min 1 nurse for each doctor Different Exam Rooms

Results 4

hour

s 11

Ho

urs

Resource Activities In the resources scenario

6 scenarios run for 4 hours and 16 Patients 50 replicate

Arrival Rate 15-30 min Nurse pool 3 Exam Rooms

Results4

Hour

s11

Hou

rs

The Best Scenario The best scenario

Arrival Rate 20-30 Min Nurse pool of 8 Multiple location

the applied scenario Is stated in the following table

Results Patients time in the system

Results

Nurse Pool utilization

Comparison

Comparison

FlexSim

FlexSim Results The simulation ran for 4 hours. 13 Exam Rooms 8 Nurses

FlexSim Results Due to the challenges the results were close, however,

further programming is required to set the patients attribute, define the percentage of New Vs. Establish patients

Conclusion Each doctor should have a number of patients

according to their processing time Changing the location availability and nurses won't

help much The Accumulation of patients are due to the arrival

rate Increasing the Exam rooms would only increase the

waiting time in the facility. “for some providers” it would be useful to have a separate data to

established and new patients.

Future Work & recommendations

Use The time specified scheduling New: 30 to 45 minutes Established patient: 15 to 20 minutes

In the time study, different processing time for new and establish patients should be collected.

Reduce the processing time for some providers

Questions?