Building mock-ups and trialing process in situ are great, if you have extra time on your hands and an open-minded staff. But often you need to be able to prove that something will work. You may analyze the data and figure out a new process that seems so obvious that it HAS to work. But without some kind of analytical model to test the new design or process, you are still guessing. It may be an educated guess. But it’s nearly impossible to consider every connection between the current and proposed state.
Computer Simulation In Healthcare
Computer simulation modeling can do this and test scenarios before you make a costly change. Most industries use simulation modeling to test aspects of their processes and designs. For instance: it’s too expensive to create a suboptimal manufacturing line. The consumer products industry uses computer simulation modeling all the time.
Yes, it’s orange juice, rather than life and death on the line. If low-risk manufacturing processes warrant computer simulation modeling, why not healthcare? Given the variability of human behavior, the rapid analysis of millions of scenarios would greatly benefit caregiving models. Shouldn’t patient care be at least as worthy of study as juice?
How do you know?
A good simulation model should allow you to quantify your current conditions. You may find issues, bottlenecks, and constraints where you didn’t expect them. The model will also validate and quantify issues you’ve known for a while. A baseline model that includes a staffing model, physical design and process flow is ready for testing options.
Change the physical design, change the operational processes, change staffing models. Change pieces and parts of all these simultaneously or individually. The model can test physical capacity, one or more staffing or process improvement ideas, and combinations to determine impact before making changes or assumptions. Often the end result is greater than the sum of the parts.
Try the reverse! Start with a goal for throughput, as an example, and see what changes are necessary to meet that new goal. You may find that you can do better than best practice.
A good simulation model uses your department’s specific processes, data, and current physical design. You know your current design, and you can observe and document your processes. You can easily get valid data from your information system. Or, if you don’t have one, from patient charts and staffing grids. With the right computer simulation expertise, you can have a baseline model up and running in a few weeks.
Here’s some examples of current challenges and what your new life will look like with computer simulation modeling.
- Administration: “Your new throughput goal is 25% less than current.”
Future You: “No sweat. I will use simulation to prioritize what to do first and the outcomes we can expect from each improvement. I will know how to proceed in a couple of weeks.”
- Administration: “We’re renovating your department. Be sure to continue to maintain the same level of care and patient satisfaction scores.”
Future You: “Bring it. I will use the simulation model to test each phasing option. Based on the one that generates the best results I’ll create processes and staffing models that ensure the waiting room volume stays low. And that door to physician and lengths of stay don’t increase.”
- Administration: “You need to shorten the length of time that patients wait for test results or discharge.”
Future You: “I have quantified that patients who are ready for discharge stay too long in the department by 45 minutes on average.”
- Present You: “I need more space, more treatment rooms, more storage, more charting area.”
Future You: “Ok I can use the simulation model to test how many spaces of each I really need relative to operational flow. I can show that changing processes will make up for a lack of treatment spaces in the short term. I can also test how long the improvements will hold and show how long before I really need to escalate the urgency.”
- Present You: “I am short on staff.”
Future You: “I can use the sim model to test various staffing models even by day of the week. I can add or subtract staff to test different models of care: team staffing, mid level providers, or the use of transporters. Then if I really need staff, I can say that the consequence of being short two techs is an ALOS thirty minutes longer than with two techs.”