This presentation was given as part of the Simulation in Healthcare Dinner sponsored by SIMUL8 at the 2014 HSPI Conference.
The presentation was given by Anna Henkel of BJC Healthcare.
• History of simulation at BJC HealthCare
• Overview of simulation applications
• Case Studies
– Mobile Pharmacy
– Preventable Harm Interventions
– OR Bed Flow
Types of data sampling,probability sampling and non-probability sampling,Simple random sampling,Systematic sampling,Stratified sampling,Clustered sampling,Convenience sampling,Quota sampling,Judgement (or Purposive) Sampling,Snowball sampling,Bias in sampling.
To Understand the interpretation of important terms related to Sample size and Sampling .
To Be able to choose appropriate Sampling.
To calculate sample size for cross sectional studies
Types of data sampling,probability sampling and non-probability sampling,Simple random sampling,Systematic sampling,Stratified sampling,Clustered sampling,Convenience sampling,Quota sampling,Judgement (or Purposive) Sampling,Snowball sampling,Bias in sampling.
To Understand the interpretation of important terms related to Sample size and Sampling .
To Be able to choose appropriate Sampling.
To calculate sample size for cross sectional studies
Usability evaluation of a discrete event based visual hospital management sim...hiij
Hospital Management is a complex and dynamic organisational challenge. Hospital managers (HMs)
are responsible for the effective use of valuable resources and assets, which is a significant issue in
healthcare. Due to factors such as the increase in health care costs and political pressure, HMs have
been compelled to examine new ways to improve efficiency and reduce healthcare delivery costs whilst
improving patient satisfaction. Healthcare managers require tools that will allow them to review the
current system or identify areas of improvement and quantify the possible changes.
This paper covers an evaluation of a hospital simulator developed by the authors. A usability test of the
simulator was carried out with hospital managers to provide real-world feedback on the simulator. This
has provided lessons to be applied in the development and use of such a tool. For instance, use of traffic
light colours in assisting management of hospital areas and Sensitivity Analysis supporting multiple or
more complex scenarios.
Brief overview of how queueing models can be be linked with big data initiatives to more accurately forecast demand
and revenues, improve care delivery pathways, plan resources and assess new projects.
Simulating Acute Bed Capacity – 7 days a week
NHS IMAS
Poster from the 'Delivering NHS services, seven days a week' event held in Birmingham on 16 November 2013
More information about this event can be found at
http://www.nhsiq.nhs.uk/news-events/events/nhs-services-seven-days-a-week.aspx
Scheduling Of Nursing Staff in Hospitals - A Case Studyinventionjournals
International Journal of Mathematics and Statistics Invention (IJMSI) is an international journal intended for professionals and researchers in all fields of computer science and electronics. IJMSI publishes research articles and reviews within the whole field Mathematics and Statistics, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Simulation modeling of pre/post bed needs for an Interventional PlatformSIMUL8 Corporation
Architect Frank Zilm discusses how simulation software was used to explore the implementation of an interventional platform concept, integrating surgery, cardiac procedures, interventional radiology and endoscopy services, at Saint Louis University Hospital.
Understand what healthcare analytics is.
Identify the 5-stage Analytics Program Lifecycle (APL).
Understand how data analytics can be used in healthcare.
Check it on Experfy: https://www.experfy.com/training/courses/introduction-to-healthcare-analytics.
Ensuring the feasibility of a $31 million OR expansion project: Capacity plan...SIMUL8 Corporation
Ensuring the feasibility of a $31 million OR expansion project: Capacity planning, system design, and patient flow
Presenter: Todd Roberts, Memorial Health System
The second workshop in our series will look at a recent project at Memorial Health System (MHS) in Illinois.
Todd Roberts, System Director of Operations Improvement at MHS will discuss and demonstrate the use of discrete simulation modeling to analyze floor design and throughput for a new Rapid Clinical Examination provider model for a 70,000 annual visit, Level I trauma center emergency department at a 507 bed, tertiary, urban, academic medical center and flow for all aspects of architectural design proposal for $31 million dollar operating room expansion project, including pre-op admission, transport to OR, OR time, and post-anesthesia care units (PACU) for admitted and outpatient surgery.
Through the use of discrete simulation modeling, Memorial has reduced length to stay for non-admitted patients in the emergency department by 27%, reduced percentage of patients leaving by without treatment by 50%, and released admit hold time by 37% while improving patient satisfaction from the 57th to 99th percentile (Press Ganey).
In addition, Memorial has used simulation to determine the appropriate facilities layout for its new OR expansion project, determining that optimizing the flow of traffic will lead to a reduction of 30 minutes per case in wasted movement and waiting.
College Writing II Synthesis Essay Assignment Summer Semester 2017.docxclarebernice
College Writing II Synthesis Essay Assignment Summer Semester 2017
Directions:
For this assignment you will be writing a synthesis essay. A synthesis is a combination of two or more summaries and sources. In a synthesis essay you will have three paragraphs, an introduction, a synthesis and a conclusion.
In the introduction you will give background information about your topic. You will also include a thesis statement at the end of the introduction paragraph. The thesis statement should describe the goal of your synthesis. (informative or argumentative)
The second paragraph is the synthesis. You will combine two summaries of two different articles on the same topic. You will follow all summary guidelines for these two paragraphs. The synthesis will most likely either argue or inform the reader about the topic.
The conclusion paragraph should summarize the points of your essay and restate the general ideas.
For this essay you will read two research articles on a similar topic to the previous critical review essay as you can use this research in your inquiry paper. You will summarize both articles in two paragraphs and combine the paragraphs for your synthesis. In the synthesis you must include the main ideas of the articles and the author, title, and general idea in the first sentences.
This essay will be three pages long and the first draft and peer review are due June 15. You must turn them in hardcopy in class so you can do a peer review.
Running head: THESIS DRAFT 1
THESIS DRAFT 3Thesis Draft
Katelyn B. Rhodes
D40375299
DeVry University
Point-of-Care Testing (PoCT) has dramatically taken over the field of clinical laboratory testing since it’s introduction approximately 45 years ago. The technologies utilized in PoCT have been refined to deliver accurate and expedient test results and will become even more sensitive and accurate in order to dominate the field of clinical laboratory testing. Furthermore, there will be a dramatic increase in the volume of clinical testing performed outside of the laboratory. New and emerging PoCT technologies utilize sophisticated molecular techniques such as polymerase chain reaction to aid in the treatment of major health problems worldwide, such as sexually transmitted infections (John & Price, 2014).
Historic Timeline
In the early-to-mid 1990’s, bench top analyzers entered the clinical laboratory scene. These analyzers were much smaller than the conventional analyzers being used, and utilized touch-screen PCs for ease of use. For this reason, they were able to be used closer to the patient’s bedside or outside of the laboratory environment. However, at this point in time, laboratory testing results were stored within the device and would have to then be sent to the main central laboratory for analysis.
Technology in the mid-to-late 1990’s permitted analyzers to be much smaller so that they may be easily carried to the patient’s location. Computers also became more ...
Testing the impact of policy decisions using simulationSIMUL8 Corporation
With many factors and risks to consider, identifying the impact of policy change can be a challenge.
Learn why simulation is used to make evidence-based policy decisions, improve program outcomes and deliver services more efficiently to the public.
Using real-life examples from healthcare to smart cities, Tom Stephenson shows the benefits of using simulation for evaluating policy changes.
In this webinar session, Dr Tracey England, Mathematical Modeller and Research Fellow at ABCi, shared three case studies of how simulation software has supported healthcare improvements at Aneurin Bevan University Health Board.
Learn how Memorial Health System have utilized simulation to answer facility planning questions – saving unnecessary costs, avoiding delays in construction, and improving patient safety and satisfaction.
Graham Prellwitz and Lance Millburg discuss the benefits of using SIMUL8 for validating healthcare facilities ahead of finalizing building plans and construction.
In this on-demand webinar session, you'll learn 4 recommendations for successful simulation projects and see how these have been applied across a range of planning projects.
Laboratories must be able to deliver quality results, at the lowest cost, within the shortest time frame.
In this webinar learn how simulation can be used to improve laboratory flow.
Watch the webinar recording: https://www.simul8healthcare.com/case-studies/improving-laboratory-flow-with-simulation
Tom Stephenson, Senior Healthcare Consultant at SIMUL8 Corporation, will discuss his experience of designing laboratory simulations and share best practice techniques.
Through real examples, you'll learn how SIMUL8 has been used to test laboratory improvements, including:
- Assessing the impact and ROI of new machinery
- Selecting optimal layouts
- Understanding how the current system will cope with demand changes
- Testing total lab automation
Merging Cath Labs: Using simulation to design a solution and understand the i...SIMUL8 Corporation
Learn how Boston Scientific used simulation to test the impact of merging Cath Labs from two different sites in a Canadian hospital.
In this live webinar session, Boston Scientific's Yixin Wang will discuss how simulation formed a key part of the change process, engaged clinicians and administrators in the redesign, and ensured consensus on the best solution.
You'll learn how the teams worked together to understand the complexities of future demand from the local population, procedure types and timings, staffing, scheduling, as well as determining the optimum design for the combined unit.
In highly congested hospitals it may be common for patients to overstay at Intensive Care Units (ICU) due to blockages and imbalances in capacity.
Watch the webinar in full at: https://www.simul8healthcare.com/case-studies/releasing-icu-bed-capacity
Reece Holbrook, Technical Fellow at <b>Medtronic</b>, discusses how simulation is being used to turn available data from clinical trials into actionable insights for hospital electrophysiology lab managers. Watch the webinar in full: https://www.simul8healthcare.com/case-studies/medtronic-bringing-data-to-life
Redefining the care team to meet Population Health objectivesSIMUL8 Corporation
Dr. Phil Smeltzer from The Medical University of South Carolina demonstrates an interactive simulation that helps physicians adopt a population health mindset.
In the third webinar of the series, Max builds on the example simulation in Sessions 1 & 2 and shows how you can control the simulation using spreadsheets, and how to link Excel to the simulation. Find out more at: http://www.SIMUL8.com/the-complete-guide-to-simul8-success
The second webinar in the series, "The Complete Guide to SIMUL8 Success." Max Guild talks us through how to get results fast using SIMUL8. Full webinar recording: http://simul8.com/the-complete-guide-to-SIMUL8-success
Improving Eye Care Outpatient Services with SimulationSIMUL8 Corporation
David Southern and Dr. Eren Demir of Pathway Communications demonstrate how simulation used to forecast demand and improve the clinical management of retinal diseases.
The first webinar in the series, "The Complete Guide to SIMUL8 Success." Max Guild talks us through how to get results fast using SIMUL8. Full webinar recording: http://simul8.com/the-complete-guide-to-SIMUL8-success-webinars
Cheryl Davenport, Director of Health and Care Integration at Leicestershire County Council, talks about how simulation is helping to evaluate how emergency hospital admissions can be reduced.
Jacquie White, Deputy Director of NHS England Long Term Conditions, Older People & End of Life Care and Claire Cordeaux SIMUL8 Executive Director for Health & Social Care were invited by Centers for Medicare & Medicaid Services to discuss how NHS England work in chronic disease.
Lance Millburg, Senior Lean Six Sigma Project Manager talks us through how Memorial Health System built their simulation team from the ground up into a nationally recognized program in 2 years.
Jacquie White, Deputy Director of NHS England Long Term Conditions, Older People & End of Life Care and Dr Eileen Pepler, Academic, Researcher and Consultant in the Canadian Healthcare will discuss how NHS England work in chronic disease is being translated into a Canadian context.
From Cars to Calls - Expanding the Limits of SimulationSIMUL8 Corporation
Sander Vermeulen presented a session with Ford Motor Company’s Capacity Manager Supervisor Tom Woods at MSUG 2015 about using simulation in other areas in your manufacturing organization. They discussed the use of simulation within contact center projects and looking at the specific examples of improving your support desk.
From Cars to Calls - Expanding the Limits of Simulation
Simulation Modeling at BJC HealthCare
1. Simulation Modeling at
BJC HealthCare
1
Anna Henkel
Transformation Support, Center for Clinical Excellence
afh2831@bjc.org
2. • History of simulation at BJC HealthCare
• Overview of simulation applications
• Case Studies
– Mobile Pharmacy
– Preventable Harm Interventions
– OR Bed Flow
Outline
2
4. History of Simulation Modeling at BJC
4
Mid-2009:
Identified
simulation as a
key opportunity
for the system
2009 2010 2011 2012 2013
Early 2010:
System-wide
in-house
training
2014
Early 2014:
In-house
SIMUL8
training
Mid 2013: Re-emphasis on
simulation modeling as a
valuable performance
improvement tool
Early 2010:
Begin using
simulation
system-wide
Late-2009:
Selection of
SIMUL8 as
BJC’s modeling
software
2014:
Integration
into Black Belt
curriculum
2013:
Attempt #2 to build
internal capacity
2011:
Attempt #1 to build
internal capacity
2014:
Attempt #3 to build
internal capacity
5. Simulation Applications at BJC
5
• Administration
• Care Coordination
• Emergency Department
• Food Services
• Nursing Units
• Operating Room
• Outpatient Medical Practices
• Pharmacy
• Planning, Design &
Construction
• Radiology
• Revenue Cycle
6. Simulation type: Staff utilization
Questions:
1. What is the effect of variation in patient utilization on prescription
turnaround time?
2. What is the effect of staff resources on prescription turnaround time?
3. What is the impact of batching deliveries on prescription turnaround time?
Case Study 1: Mobile Pharmacy
6
Inputs (variables) Outputs Controls
• Patient utilization
• Delivery batch size
• Staffing models
• Prescription turn
around time
• Resource utilization
• House-wide patient
census
• Delivery time
7. Case Study 1: Mobile Pharmacy
7
Future State (45% Patient Utilization)
8. Results/Decision/Recommendations:
• With increased patient utilization, resource need less than originally
estimated
– i.e. originally anticipated adding 4 scanning stations to overall Mobile Pharmacy
workflow; simulation model revealed that only 2 additional scanning stations
necessary
Project Benefits:
• Prospective understanding of impact of increased patient utilization
• Validation of resource requests/new hires prior to initiating process
Case Study 1: Mobile Pharmacy
8
9. Simulation type: Staff utilization
Questions:
1. What is the impact of varying patient acuity and patient census on staff
capacity required for executing falls and pressure ulcer interventions?
Case Study 2: Preventable Harm Interventions
9
Inputs (variables) Outputs Controls
• Frequency of
interventions
• Patient length of stay
• Patient census
• Type of staff to
respond
• Staff utilization
• Intervention time by
patient fall & pressure
ulcer acuity level
• Bed capacity
• % isolation patients
• Distribution of falls
acuity
• Distribution of
pressure ulcer acuity
10. Case Study 2: Preventable Harm Interventions
10
Pressure Ulcer
Prevention
Fall Prevention
12. Case Study 2: Preventable Harm Interventions
12
“Low” fall risk patients ( ~12 patients)
“Moderate” fall risk patients (~23 patients)
“High” fall risk patients (~15 patients)
13. Results/Decision/Recommendations:
• Over 12 hours of a 24-hour time period is spent on fall and pressure
ulcer interventions for the average patient census
Project Benefits:
• Limited role differentiation for fall & pressure ulcer interventions
between staff revealed processes that neglected human potential
• Importance of clarifying standard protocol: model revealed that
some low risk patients required more staff time because of unclear
intervention protocol
Case Study 2: Preventable Harm Interventions
13
14. Simulation type: Bed flow
Questions:
1. What is optimal number of pre-op and post-op beds?
2. What is the impact of shared pre-op/post-op beds?
3. How does families waiting in the pre-op/post-op bay affect flow?
Case Study 3: Pre-Op and Post-Op Bed Utilization
14
Inputs (variables) Outputs Controls
• Case mix
• # Available pre-op &
post-op beds
• Use of space
(shared/separate,
families occupy room)
• Utilization by bed type
(pre-op, post-op &
shared)
• Number of ORs
• ASA scores
16. Results/Decision/Recommendations:
• Recommended number of beds ranged from depending on bed use
scenario (shared/separate bed pool, case load, bed use)
Project Benefits:
• Families staying in pre-op room had limited impact on number of
beds required (requirement increased by 1 bed)
• Standard ratio of pre-op/post-op beds to ORs (4:1) did not hold for
every scenario
– Impacted by unique needs of the pediatric population
Case Study 3: Pre-Op and Post-Op Bed Utilization
16