University of Twente Student Theses

CT processes imitated: the development of a simulation model of CT processes at Campbelltown Hospital to improve the ability to anticipate on the impact of changes and to evaluate current practice

Bruin, Marten de (2010) CT processes imitated: the development of a simulation model of CT processes at Campbelltown Hospital to improve the ability to anticipate on the impact of changes and to evaluate current practice.

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Abstract:	Hospital emergency departments (EDs) within Australia are under increasing pressure to deliver quality because of a growing demand for their services. The increasing levels of ED activity can result in major problems because the capacity of hospital EDs is limited. Campbelltown Hospital, a public hospital delivering health care services in the south west area of Sydney, is experiencing the increasing levels of ED activity over the last couple of years and is confronted with recurrent access blocks. The diagnostic services delivered by the ID are of high importance to the ED. Stakeholders experience diagnostic services as a barrier for patient flow inside the ED. The Centre for Industry and Innovation (CInIS) from the University of Western Sydney was invited to do research on this problem. The project undertaken by CInIS is called the Visual Optimisation of Patient Flow in Hospital Emergency Departments. The aim of this project is to optimise patient flow in the ED of Campbelltown Hospital via the analysis of work processes using interactive computing simulation. Previous research within this project has given insight in the processes around Ultrasound (US), and a simulation tool was developed for the US processes to simulate improvement strategies. The next step is to do the same for the other ID services. This specific study focuses on the CT processes at Campbelltown Hospital. The goal of this study is to provide Campbelltown Hospital with a versatile and comprehensive simulation tool of CT processes that improves the ID manager's ability to anticipate on the impact of changes, as well as to evaluate the effectiveness of the current practices. To achieve this goal, current CT processes were mapped and described using qualitative data. These data were gathered by observation on working days and semi structured interviews with CT radiographers, administrative staff and the manager of the ID. Next, quantitative data was collected over a period of 13 weeks to analyse the current performance of CT processes, and to specify model parameters and input probability parameters for the simulation model. The data was combined and compared with existing data from ward orderly books, CT logbooks and imaging request forms. Finally, a computer model was constructed and validated. In conclusion, we partly succeeded in providing Campbelltown Hospital with a versatile and comprehensive simulation tool of CT processes that improves ID manager's ability to anticipate on the impact of changes, as well as to evaluate the effectiveness of the current practices. Changes in operating procedures can easily be adapted in the computer model and therefore it becomes easy to experiment with different configurations. On the other hand, we failed in introducing the factors that result in the current waiting times, which makes it impossible to evaluate the effectiveness of all of the current practices. We recommend that upfront processes of CT, especially (re)scheduling and transportation, are extensively analysed in order to create insights that can be used to improve the simulation model and to create alternative configurations which can be compared. The current model shows us that the available CT capacity is well enough to meet the current demand. Waiting times are mainly a result of the current system of planning and scheduling. As demonstrated within the simulation model, the introduction of a walk-in principle at the ID is a possible solution to lower waiting times substantively. Boundary conditions for the introduction of such a system therefore have to be explored. When integrated in the model, their influence can also be quantified. Maybe even less rigorous interventions in the current system of planning and scheduling can also have a major impact on the current waiting times. But if this system remains undefined, no alternative configuration can be created in the simulation model and no conclusions can be drawn about the effectiveness of possible improvements in this system. At the start of this study it was known that the model created during this study will eventually be combined with simulation models from the other diagnostics services delivered by the ID. During the integration of the different models it is important to include shared departmental facilities, like patient transportation by wardsmen and the availability of nurses. Since more variables are introduced for which different configurations can be simulated, this will improve the ability to anticipate on the impact of changes, as well as to evaluate the effectiveness of the current practices.
Item Type:	Essay (Bachelor)
Clients:	CInIS
Faculty:	BMS: Behavioural, Management and Social Sciences
Subject:	85 business administration, organizational science
Programme:	Industrial Engineering and Management BSc (56994)
Link to this item:	https://purl.utwente.nl/essays/60861
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