Accessible Simulation Methods to Support Healthcare Improvements
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- Gervase York
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1 Accessible Simulation Methods to Support Healthcare Improvements Claire Cordeaux: SIMUL8 Corporation Michele Stuart: Efficiency Engineers Stephen Burrows: NHS Institute Worldwide
2 Who are we? Claire Cordeaux: Lead for Healthcare, SIMUL8 Corporation Michele Stuart: President, Efficiency Engineers Stephen Burrows: NHS Institute Worldwide
3 Agenda 1. What is discrete event simulation? 2. Why isn t everyone using it? 3. Methodologies and solutions developed to make simulation more accessible to health Focused simulations (Claire) Limited features for specific questions (Claire) The Geisinger Experience (Michele) The Productive Ward (Stephen) 4. Questions
4 Claire Cordeaux Claire Cordeaux SIMUL8 Corporation Discussing new applications and techniques which are helping healthcare organizations to gain the benefits of simulation
5 Simulation: Explained Models a flow of events Allows for the passing of time and expected changes Shows resulting demand, cost and resource implications
6 A simple simulation
7 The benefits of simulation Risk- Free Uses data intelligently More accurate than a spreadsheet Models variability Increases confidence in decision making Test and compares potential solutions Simulates the passing of time Visual- Engages Stakeholders
8 Planning for Healthcare How much can I spend? How much resource have I got? What is my demand likely to be? How long is it reasonable for patients to wait? What are my expected outcomes?
9 Slow adoption in healthcare The academic research... Resistance to manufacturing industry methods Constant change Cost of software and consulting advice Lack of in-house expertise Lack of useful data Academic simulations too large and complex
10 Slow adoption in healthcare What healthcare staff tell us... Too difficult I have a big problem to solve by next month. I haven t got time to learn a new technique AND solve the problem
11 Making it easier Our tools and techniques...
12 Creating focused simulations Common healthcare questions One specific issue to solve Pre-loaded scenarios User interface to localize specific aspects Graphics to aid understanding Dialogs to guide user interface Results in format to embed in business case
13 Example: Dementia simulation
14 Limited features Common healthcare applications Variety of questions - requires flexibility Only requires features limited to those applications
15 Example: SimLean Combines simulation and Lean in hospitals Features: Arrivals Patient types Processes Queues Time Graphics
16 Example: Scenario Generator Strategic planning whole system Features: Pre-loaded data and algorithms driving arrivals Processes Time Cost Volume Queues
17 Michele Stuart Michele Stuart Efficiency Engineers Sharing how simulation techniques are enabling the improved efficiency and effectiveness
18 The Geisinger Experience Complete/Complex Healthcare System Hospitals Clinics Physicians Insurance Data driven society Always interested in new tools, if well credentialed
19 The Geisinger Experience HELP Healthcare Enabled Logistics Project Problem: How to reduce nursing time (15-20%) spent performing logistics - retrieving, searching, ordering?
20 The Geisinger Experience HELP Healthcare Enabled Logistics Project Solution: Master model of all logistics interaction, worked with each group for details and validation Results: System-wide visual for the first time Discovered over 35 different groups delivering to inpatient units!! Consolidation of silos underway
21 The Geisinger Experience Pneumatic Tube Optimization Problem: How to see, test, and gain acceptance for updates to this core delivery system? Solution: Convert key internal knowledge into interactive tool Results: Reduce critical path times Lab samples Low risk and easier justification for designing expansions/department relocations
22 The Geisinger Experience On Demand Food Delivery Problem: Innovation to have on-demand instead of scheduled food delivery Solution: Master s thesis collecting internal and research to determine new structure to guarantee delivery within minutes of request Results: New process design for staffing, scheduling, space Lets team test brainstorm ideas - inclusive and expansive
23 The Geisinger Experience Bed Turnover Analysis Problem: Wait for inpatient beds clogging ER, bed turnover time the issue Solution: Conflicting solutions from different sectors needed to be tested for optimum solution Results: Only required one additional staff to reduce turnover time by 40% across the hospital
24 The Geisinger Experience Other Questions being Handled: Case Managers Workload Analysis What is the optimum mix for a Case Manager to guarantee service & quality levels? Health Managers Scheduling How often should patients be touched to decrease hospital re-admissions?
25 The Geisinger Experience Expanding Accessibility: Users Group to share data, models, and experience Rollout as tool for the Quality Institute to bring the live value stream map to the operations level Involve C level and use for strategic planning as new hospitals brought into system
26 Stephen Burrows Stephen Burrows NHS Institute for Innovation and Improvement Worldwide Will provide insight into work in Care Oregon where nurses are engaged in the use of simulation to release their time to care for patients.
27 Releasing Time to Care A front-line, top-enabled approach to improving care Unit-based to preserve your unique culture while standardizing nursing processes Based on Lean principles using language created by and for nurses Structured, continuous quality improvement A way to build leadership at the front lines of care
28 Releasing Time to Care Lasting innovation and improvement come when staff are fully engaged. Releasing Time to Care is a very effective way to make this happen. RT2C organizes the LEAN tools in such a way that an already excellent staff can become more efficient, more effective and happier with their jobs. We appreciate the leadership that Care Oregon has shown. Karen Logsdon, Nursing and Patient Care Chief Nursing Officer, Providence Portland Medical Center
29 RT2C Simulation
30 Working together Community approach overcoming obstacles to using simulation Join our community at simhealthcare.com to share experience, tools and techniques Come and see us at Society for Healthcare Systems February Mirage Hotel, Las Vegas
31 Questions?
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