final presentation 111
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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?