Real-Time Simulation of Patient Care Processes in Healthcare

Abstract

The increasing waiting times to access healthcare services are a major concern for pa-tients in hospitals. Due to the unpredictability of health issues, hospitals and clinical ser-vices are provided to patients even without prescheduled medical appointments. Unex-pected and random patient arrivals can result in high waiting times. Waiting occurs most-ly because of insufficient resources available compared to demanding service delivery requirements at a given time. Thus, appropriate management of resource scheduling over time can help reduce patient wait times. So far, simulation has mostly been used as a support for strategic decision making in healthcare environments. We are proposing a complementary approach, namely, real-time simulation, to support operational decision making rather than long-term strategic decision making. Real-time simulation is a technique used to get a timely prediction of the system status in a near future (e.g., a few hours). Hospitals can benefit from the capa-bilities of real-time simulations by predicting upcoming bottleneck occurrences in patient care processes and make effective decisions in the present time to avoid undesirable out-comes in the near future. This research presents real-time simulation capabilities for short-term operational decision making of patient care processes in hospitals and the possible ways to run alter-native scenarios and evaluate their results to come up with the most effective solution considering various factors. This thesis also provides tool support based on a leading simulation environment, namely Arena. The tool-supported methodology is evaluated through a realistic cardiac care process in an Ontario community hospital, with encourag-ing results.