Designing improved healthcare processes using discrete event simulation
A new tool for analysing and redesigning processes in clinical services
has been developed and tested in a service-improvement project at Good Hope
Hospital. The application of advanced IT to clinical-process redesign using
the evidence-based principles of a formal research methodology has enabled
the staff of the vascular-surgery clinic to provide a better service for
patients, a better working environment and better value for money for the
taxpayer. Mr Simon Dodds, who created the necessary simulation tool,
describes how the hitherto elusive result was accomplished.
ABSTRACT
Over the past four years the vascular-surgery outpatient service at Good
Hope Hospital has been re-engineered. Conventional ‘suck-it-and-see’ methods
were replaced by evidence-based design of improved patient-centred care
processes using a combination of casemix analysis and discrete event
simulation (DES).
A new software tool called the Care Pathway Simulator (CPS) was developed
to meet the unique requirements of this novel approach in order to predict
accurately the behaviour of the complex system resulting from the
interaction of multiple patients following different care pathways and
competing for shared resources. The CPS tool identified and quantified the
problems within the existing processes that limited capacity (ie the
bottlenecks); allowed us to test a range of proposed solutions using a
virtual process model; and provided objective evidence to support
implementation of the proposed solution.
Just as importantly, the CPS tool allowed the relationship between
performance and resource availability to be mapped and the point at which
system failure is imminent to be seen — allowing time for predesigned
escalation policies to be activated. The enhanced performance predicted by
CPS was confirmed in practice.
Process-design tools based on discrete event simulation do appear to work
in healthcare provided that the unique requirements of healthcare processes
are taken into account and those who use these tools are appropriately
trained and experienced.
Br J Healthcare Comput Info Manage 2005; 22(5): 14–16. |
