Hospital event simulation model: Arrivals to discharge

David Ben-Tovim, Jerzy Filar, Paul Hakendorf, Shaowen Qin, Campbell Thompson, Dale Ward

    Research output: Chapter in Book/Report/Conference proceedingConference contribution

    1 Citation (Scopus)

    Abstract

    Many Australian public hospitals operate under strict resource constraints. Arguably, this is manifested in higher incidence of ambulance ramping and patient flow congestion episodes, which has led to an increase in public complaints and, possibly, sub-optimal health outcomes for patients. Consequently, there is a well accepted need to make best use of all available information and domain knowledge to ensure that hospital resources and expertise are utilised more efficiently, for the benefit of patients. The latter is not a simple task since hospital operations involve complex interactions among many groups of health professionals utilising limited physical facilities and equipment. This is further complicated by the inherent variability of patient responses to treatments. Indeed, the stochastic nature of the demand process, as well as uncertainty in durations of medical treatments and patient recovery, lead to probabilistically distributed bed availability. Fortunately, in Australia, hospitals are”data rich” in the sense that reliable records of patient journeys have been kept for many years. While older data may reflect procedures and priorities that are no longer in place, data from recent years may be regarded as quite robust, especially in cities that have not experienced major demographic changes. Thus there is an opportunity to apply modern tools of mathematical, statistical and simulation modelling to enhance our understanding of key processes that influence a hospital's operations. The understanding so obtained can then be used to assist hospital staff in devising operational procedures that are likely to minimise disruption without adversely impacting the public service provided to the patient population. In this paper we outline the Hospital Event Simulation Model: Arrivals to Discharge (HESMAD) to describe the patterns of patient flows within the Flinders Medical Centre, an urban teaching hospital. The logical design of HESMAD was developed through extensive consultation with colleagues from the hospital. In particular, patients within HESMAD are not modelled as identical entities, rather, they are assigned different attribute values such as mode of arrival, triage category and division to reflect the typical profile of all patients. Patients go through a set of physical units and process modules that model various physical areas, processes, interactions and behaviours within the hospital to replicate a wide spectrum of patient journeys. Hospital and patient data from 2012 to 2013 were used to fit various probability distributions, for instance the waiting times for treatment or discharges. The model allows for a realistic representation of patient flows, at a level of resolution that was deemed appropriate by the hospitals data management experts. The model has been validated against historical data and through consultation with health care and hospital experts. Within space limitation we provide an outline and a brief discussion of HESMAD's structure, features, capabilities, design decisions and development. In addition, we provide a brief case study demonstrating the potential applicability of HESMAD for'what if' analyses of hospital interventions. While all discussions are specific to the Flinders Medical Centre, the methodology used within HESMAD is generic enough to apply to other public hospitals in Australia.

    Original languageEnglish
    Title of host publicationProceedings - 21st International Congress on Modelling and Simulation, MODSIM 2015
    EditorsTony Weber, Malcolm McPhee, Robert Anderssen
    PublisherModelling and Simulation Society of Australia and New Zealand Inc. (MSSANZ)
    Pages1640-1646
    Number of pages7
    ISBN (Electronic)9780987214355
    Publication statusPublished - 2015
    Event21st International Congress on Modelling and Simulation: Partnering with Industry and the Community for Innovation and Impact through Modelling, MODSIM 2015 - Held jointly with the 23rd National Conference of the Australian Society for Operations Research and the DSTO led Defence Operations Research Symposium, DORS 2015 - Broadbeach, Australia
    Duration: 29 Nov 20154 Dec 2015

    Publication series

    NameProceedings - 21st International Congress on Modelling and Simulation, MODSIM 2015

    Conference

    Conference21st International Congress on Modelling and Simulation: Partnering with Industry and the Community for Innovation and Impact through Modelling, MODSIM 2015 - Held jointly with the 23rd National Conference of the Australian Society for Operations Research and the DSTO led Defence Operations Research Symposium, DORS 2015
    CountryAustralia
    CityBroadbeach
    Period29/11/154/12/15

    Keywords

    • Discrete event simulation
    • Hospital operation
    • Modelling
    • Poisson processes
    • Simulation

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  • Cite this

    Ben-Tovim, D., Filar, J., Hakendorf, P., Qin, S., Thompson, C., & Ward, D. (2015). Hospital event simulation model: Arrivals to discharge. In T. Weber, M. McPhee, & R. Anderssen (Eds.), Proceedings - 21st International Congress on Modelling and Simulation, MODSIM 2015 (pp. 1640-1646). (Proceedings - 21st International Congress on Modelling and Simulation, MODSIM 2015). Modelling and Simulation Society of Australia and New Zealand Inc. (MSSANZ).