| 1. |
- Fryk, Pontus, et al.
(author)
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A modern process perspective, process mapping, and simulation in health care : Opportunities and IT infrastructural needs
- 2010
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In: Proceedings of 2010 IEEE Workshop on Health Care Management (WHCM). - 9781424449989 - 9781424449972 ; , s. 1-6
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Conference paper (peer-reviewed)abstract
- Today, health care organizations often claim that theyare “process oriented”, and that one should approach health carefrom a process perspective in order to utilize the present ITrelated benefits; such as increased service quality, cost efficiency,and enhanced communication. In this paper we investigate howwell founded the concept of process orientation really is – byexamining IT/IS infrastructures, and procedures for processdefinition, visualization, and evaluation – at a prominent hospitalin Stockholm, Sweden. A case study of the organization and theinteraction of the emergency and radiology departments at thesame hospital (using process mapping and data analysis) revealsdata fragmentation, incompatible data, and disparateinformation systems. This results in difficulties regarding processdefinition and analysis, which makes the use of innovative toolssuch as simulation, problematic. The implications of this, and thecontextual factors, are also discussed and some finalrecommendations for smooth digitization are put forth.Today, health care organizations often claim that theyare “process oriented”, and that one should approach health carefrom a process perspective in order to utilize the present ITrelated benefits; such as increased service quality, cost efficiency,and enhanced communication. In this paper we investigate howwell founded the concept of process orientation really is – byexamining IT/IS infrastructures, and procedures for processdefinition, visualization, and evaluation – at a prominent hospitalin Stockholm, Sweden. A case study of the organization and theinteraction of the emergency and radiology departments at thesame hospital (using process mapping and data analysis) revealsdata fragmentation, incompatible data, and disparateinformation systems. This results in difficulties regarding processdefinition and analysis, which makes the use of innovative toolssuch as simulation, problematic. The implications of this, and thecontextual factors, are also discussed and some finalrecommendations for smooth digitization are put forth.
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| 3. |
- Steins, Krisjanis, 1971-, et al.
(author)
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A generic simulation model for planning critical care resource requirements
- 2013
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In: Anaesthesia. - : Wiley. - 0003-2409 .- 1365-2044. ; 68:11, s. 1148-1155
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Journal article (peer-reviewed)abstract
- Intensive care capacity planning based on factual or forecasted mean admission numbers and mean length of stay without taking non-linearity and variability into account is fraught with error. Simulation modelling may allow for a more accurate assessment of capacity needs. We developed a generic intensive care simulation model using data generated from anonymised patient records of all admissions to four different hospital intensive care units. The model was modified and calibrated stepwise to identify important parameters and their values to obtain a match between model predictions and actual data. The most important characteristic of the final model was the dependency of admission rate on actual occupancy. Occupancy, coverage and transfers of the final model were found to be within 2% of the actual data for all four simulated intensive care units. We have shown that this model could provide accurate decision support for planning critical care resource requirements.
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| 4. |
- Steins, Krisjanis, 1971-
(author)
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Discrete-Event Simulation for Hospital Resource Planning : Possibilities and Requirements
- 2010
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Licentiate thesis (other academic/artistic)abstract
- The delivery of health care services has been under pressure due to limited funding and increasing demand. This has highlighted the need to increase not only the effectiveness but also the efficiency of health care delivery. Discrete-event simulation has been suggested as an analysis tool in health care management to support the planning of health care resources.The overall purpose of this thesis is to investigate the possibilities and requirements for using discrete-event simulation in analyzing and planning the use of hospital resources. This is achieved by three case studies that focus on improvements in patient flow of emergency patients that require a radiology examination, intensive care unit capacity planning and operating room allocation strategies, respectively.The first case investigates the current stage of digitization and process orientation in hospital care as a prerequisite for efficient process simulation and analysis. The study reveals an emergency-radiology patient flow process that is not very well measured and uncovers disparate information systems storing incompatible and fragmented data. These results indicate that the current degree of process orientation and the current IT infrastructure does not enable efficient use of quantitative process analysis and management tools like simulation.In the second case the possibilities to develop generic hospital unit simulation models by building and validating a generic intensive care unit (ICU) model are explored. The results show that some of the modeling approaches described in literature cannot replicate the actual behavior observed in all studied ICUs. It is important to identify patient groups for different admission priorities, to account for over-utilizations in the model logic, and to discover and properly model dependencies in the input data. The research shows that it is possible to develop a generic ICU simulation model that could realistically describe the performance of different real ICUs in terms of occupancy, coverage and transfers.The value of simulation modeling in health care management is examined in the third case through the development and use of a simulation model for optimal resource allocation and patient flow in a hospital operating department. The goal of the simulation modeling in this case was to identify bottlenecks in the patient flow and to try different alternatives for allocation of operating room capacity in order to increase the utilization of operating room resources. The final model was used to evaluate four different proposed changes to operating room time allocation.
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| 5. |
- Steins, Krisjanis, 1971-, et al.
(author)
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Increasing Utilization in a Hospital Operating Department Using Simulation Modeling
- 2010
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In: Simulation (San Diego, Calif.). - : SAGE. - 0037-5497 .- 1741-3133. ; 86:8-9, s. 463-480
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Journal article (peer-reviewed)abstract
- This article focuses on the planning and scheduling of operating rooms (ORs) in a regional hospital in Sweden. A simulation study was carried out to find new ideas and new planning and scheduling techniques to improve the overall process of surgery, including pre- and post-operating activities. This study mainly addresses the problem of low utilization of the ORs, and also takes into consideration problems with variation in workload, both in ORs and in post-anesthesia care units. The final simulation model includes pre-operative care carried out in the operating department and all ORs, as well as post-operative care units. It was driven by a number of input parameters, such as the volume and specific characteristics of actual cases, opening hours and number of ORs, and the number of beds for pre- and post-operative care. The model also includes logic for prioritizing and allocating cases to available ORs, planning operating schedules and the utilization of medical equipment limited in quantity. Output performance measures from simulation experiments include the utilization of allocated OR times, waiting time for patients, queue dynamics, number of cancellations, and variation of finishing times, as well as occupancy statistics in the post-operative care unit. Four different change alternatives were evaluated using the simulation model. Simulation experiments showed that with the implementation of the proposed changes it is possible to achieve slightly better and more even resource utilization, as well as provide greater flexibility in scheduling operations.
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