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A Percept FlowModel is the vehicle we use to take the information stored in your PatientFlow drawings and test the operation of your Patient Flows using simulation modelling techniques.
Focused_On Health believe that the problem of designing and planning procedures in the Health Care domain can only rarely be addressed using spreadsheet techniques and therefore choose simulation modelling as their preferred approach. For a rationale of this, please see Spreadsheeets compared to Simulation Modelling (PDF).
Once your simulation FlowModel has been built it will be calibrated against reality to ensure its accuracy and completeness. When calibration is complete, your "What If" scenarios can be investigated, varying demand and resource provision (both numbers and shifts) and the impact of varying workloads can be seen in terms of variation in Patient waiting time, Waiting Lists, staff workloads, bed occupancy, and revenue via PbR (Payment by Results).
A Demand and Capacity Planning FlowModel for an ICU is shown below.
In this simulation model, with 6 Beds and 8 Nursing Units (4 Nurses per shift) the results show that no refusals or cancelled elective operations occurred through lack of Beds. Nursing time was the reason for all refusals. The block on the lower left (The Evolutionary Optimizer) varied Nursing provision and Bed Provision until optimum levels were found. In this case the measure used to optimise took account of the costs of the Physical Bed, the cost of a Cancelled Operation and the cost of extra Nursing in the ICU. With the Patient demands for this Unit, the optimum balance was found to be 9 Beds and 7 Nurses.
Some of the other simulation FlowModels we have built include:
The Stepped Care approach to providing Mental Health services is analysed to specify the Therapies (CBT, NLP, etc) plus the Counsellors & Therapists required to fulfil Patient needs. The resulting Patient Flows (Care Pathways) are used to inform a simulation model so that various Patient Demand & Resource Capacity scenarios might be examined and tested. The PCT is then better able to optimise its IAPT commissioning strategies.
A CCU OutReach Nurse worked with us to build the 4 main PatientFlow pathways in a CCU (Definite MI, Suspected MI, LVF and Arrhythmia). The simulation FlowModel was built to investigate the impact of Bed blockages in the Medical Ward on the ability of the CCU to deliver its Specialised Care
This is a 3 state Markov-style simulation FlowModel which considers a cohort of Elderly Patients suffering Multiple long-term Conditions. It was designed to test Strategies aimed at reducing avoidable Emergency Admissions.
How well do your Surgical Wards cope with their mix of Minor & Major procedures for both Emergency & Elective admissions, plus any ‘failed’ Day Cases? Do Outliers from Medical Wards impact your Surgical throughput? Would you gain via PbR if Social Services were better equipped to handle Bed Blockages?
Stroke victims stay in their acute specialist unit for 3 to 14 Days and will need light to intensive support from a wide range of social and healthcare professionals before they can be Discharged or transferred to Rehabilitation. How should these teams (Doctors, Physios, OTs, SALTs, Dieticians etc.) be coordinated with basic Nursing and Medical care and what are the criteria for a sufficient input of resources?
What is causing your Waiting Lists? How confident are you that you have the right solution? Is the real bottle-neck at the Clinics, or is access to Diagnostics? Maybe you lack Theatre time or do you have enough Surgeons doing suffient Day Cases? How many Beds do you need ?
Basingstoke A&E was already achieving the 4-Hour Target, but how would they cope when Patient demographics and demand changed? What if a neighbouring A&E was closed?
How can we design NHS 'Lean Thinking' processes to deliver the most appropriate Diagnostic Tests, Assessment and Care to Patients promptly and economically? How can we avoid the undesirable prolonged stays in Assessment Units?
A demonstration FlowModel that you can play with and simulate how GP Referrals can impact Bed Occupancy.
If you have Patient Flow or Demand & Capacity problems in any of these or similar areas Contact Us to see whether we might help you analyse your problems and progress to evidence based proposed solutions.
OPTIMISED RESOURCES : GREATER PATIENT CARE