Healthcare cost has drastically increased in the past few decades, at the same time these organizations are being stressed to provide high quality healthcare for their patients in order to gain patient satisfaction. For overcoming this hurdle, organizations have started to implement simulation in their sectors for minimising the total cost spent on healthcare so that they can increase their patients flow as well as their satisfaction.
Technology growth has led to the rapid development of simulation software in such a way that it could be used for numerous new applications, including sophisticated implementation as well as combining simulation and optimisation for integrated facilities. The health sector is made up of hospitals, medical and dental practice work, nursing homes, complementary medicine, ambulance transportation, and other human health activities, such as laboratory services, across a wide range of organisations within the private, voluntary and public sectors.
Therefore, there are numerous opportunities for simulation in Healthcare Sector and in order to obtain an overall reduction in cost and improvement in quality each department of the organisation must be simulated.
Incorporating Simulation in various Healthcare Sectors
1. Hospital Bed Utilization:
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Achieving effective bed utilization is the major concern for most of the hospitals. They are often facing two prevalent problems, its either under-utilization or over utilization of beds which differs with the services that are being provided in the hospital and according to this they have to either expand or minimise their holding capacity.
The principal factors affecting the utilization of beds are:
- Bed allocation for patients
- Patient placement policies
- Patient admission policies
These factors must be formulated properly in order to achieve bed utilization and for gaining this, simulation must be carried out before installing the real time system.
2. Hospital Emergency Department:
An Emergency Department gets hectic when there is a shortage of qualified staffs during patients flow which leads to a stressful environment because the department is working for overtime for obtaining patient satisfaction. Stressful environments never give fruitful results. Mental stress may lead to unnecessary incidents and that too emergency section is a sensitive area where the staffs must be calm, polite and sensible.
While expanding a hospital's emergency ward the following factors must be considered:
- Staff capacity
- Number of beds
- Hospitals locality must be considered with which we can judge the rate at which patients will come.
- Material resource and storage capacity
- Alternative staffs who can come in case of shortage of permanent staffs
The above points must be fed into the simulation software and the program must be simulated in order to find out the queuing time in that section so that necessary action can be implemented while construction.
3. Out Patient Ward:
OP ward is the only place in a hospital where patients flow will be enormous all through the day (varies depending up on the hospitals timing) so it's the first and foremost duty of the management is to make sure that the patients are being attended properly.
Patient's arrival rate is unpredictable in this ward but few criteria's can be considered for getting an approximated value. There will be patients who might have to consult the doctor continuously for a couple of days and also based on the locality of the hospital the capacity of the ward must be altered.
The queue length must be under control and the queue timing must be as low as possible which can be achieved by increasing the number of doctors or by decreasing the queue length, but a decrease in queue length might lead to reduced patients flow or congestion among them. Simulation has a great opportunity in this section. Number of patients, number of doctors, queue length can be considered as input factors for simulating a model so that we can get an idea about the real time application.
4. AMBULANCE SERVICE:
Ambulance service and Emergency ward are interrelated because in most situations trauma and other emergency cases are brought in using ambulance service. In addition to this, if the hospitals ambulance service is good then patients from any part of the city will ring up to the hospital in case of emergencies cause of which patients flow will increase.
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There are various methods for improving the ambulance service in a hospital, few among them are:
- Having adequate ambulances in working condition
- Separate garage for maintenance and repair of ambulances
- Ambulance centres must be provided in various parts of the city and not just within the hospital campus
- Separate entry must be allocated for patrol ambulances
- Separate routes must be laid for ambulances for improving its effectiveness
Using 3D simulation, ambulances and their travel routes can be designed with which short and effective routes can be determined. Incorporating the obtained result will increase the hospitals ranking in the long run.
5. Management of Operations in Pharmacy:
A Pharmacy is the heart of any hospital because life saving medicines is being bought, stored and supplied by this section with which the doctors help the patients in recovering. A lot of data's have to be entered and maintained in a pharmacy, it includes:
- Purchase order
- Received list
- Storage capacity
- Most utilised medicines
- Expiry dates of medicines
- Emergency, regular and outdoor orders
All these information's and much more data's must be maintained in order to balance the flow of medicines and to avoid the shortage of medicines. Simulating the inward and outward flow of medicines along with the buffer storage is much needed for preventing the run out of medicines. It should also be made sure that, technicians are available for helping the patients because there is no point in just having the adequate medicines without having proper pharmacist.
Simulation has a major role to play and it's obvious that it's already playing an extraordinary role for designing organizations. Above mentioned sections are the vital places where simulation must be applied before starting actual design and construction so that the healthcare sectors performance will be improved on the whole.
List of References
1. Jun JB, Jacobson SH, Swisher JR (1999) 'Application of discrete-event simulation in healthcare clinics'. The Journal of the Operational Research Society [online] 50 (2), 109-123. Available from <http://www.jstor.org/pss/3010560> [20 March 2010]
2. All business (2010) Improving critical care: Simulation is used to improve a hospital's emergency department [online] available from <http://www.allbusiness.com/health-care/health-care-facilities-clinics/7340343-1.html> [20 March 2010]
3. Dumas MB (1985) 'Hospital bed utilization: an implemented simulation approach to adjusting and maintaining appropriate levels'. Health Services Research [online] 20 (1), 43-61. Available from <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1068864/?page=10> [21 March 2010]
4. Arup K. Mukherjee(1991) 'A Simulation model for management of operations in the pharmacy of a hospital'. Simulation [online] 56 (2), 91-103. Available from <http://sim.sagepub.com/cgi/content/abstract/56/2/91> [21 March 2010]
5. Rockwell Automation (2010) Arena Simulation Software by Rockwell Automation: Health Care Simulation [online] available from <http://www.arenasimulation.com/Solutions_Health_Care.aspx> [21 March 2010] 6. Prospects (2010) Health Overview [online] available from <http://www.prospects.ac.uk/cms/ShowPage/Home_page/Explore_job_sectors/Health/overview/p!eigalk> [21 March 2010] MODULE: Manufacturing and Management Simulation
5. Rockwell Automation (2010) Arena Simulation Software by Rockwell Automation: Health Care Simulation [online] available from <http://www.arenasimulation.com/Solutions_Health_Care.aspx> [21 March 2010]
6. Prospects (2010) Health Overview [online] available from <http://www.prospects.ac.uk/cms/ShowPage/Home_page/Explore_job_sectors/Health/overview/p!eigalk> [21 March 2010]
MODULE: Manufacturing and Management Simulation