This research integrates discrete event simulation (DES) and agent-based simulation (ABS) to help managers examine, plan, and compare different spatial design schemes through the modeling of patient behavior, patient flow, and the establishment of evaluation indexes.
Finally, the feasibility and practicability of the methodology is verified by a case study about the healthcare facility planning of the orthopedic patient clinic. On-site surveying and monitoring data and realistic medical data are used in this case model.
Hospital planning case study
To provide a better environment and services, Shanghai 6th People’s Hospital plans to build a new hospital building, with an orthopedics clinic on the second and third floors.
There are two proposed new hospital layout plans designed by a design institute. Both plans meet the requirements of medical building regulations. The difference between the two layout schemes is the setting of the inspection rooms.
The pros and cons of hospital designs depend on the evaluation indexes chosen. The evaluation indexes from the patients’ perspective include patient time in the system, patient waiting time, patient travel distance, patient throughput, and so on. And the clinics always care about the resource (healthcare personnel, medical facilities, etc.) utilization efficiency.
Patient flow is the process by which a hospital implements basic medical service functions. It is the internal medical service process and procedures of the hospital. In the comparison and selection of hospital facility plan alternatives, it is necessary to make full consideration of the corresponding patient flow.
Simulation of patient flow in a hospital
In this study, the research team uses discrete event simulation (DES). DES is a computer-based methodology that provides an intuitive and flexible approach for representing complex systems. In this paper, the DES model represents the patient flow in the healthcare facility.
To model the human discretion factor in a simulation model agent-based simulation (ABS) is proposed. And the integration of DES and ABS can take advantage of both approaches.
To support DES and ABS and allow us to efficiently combine them with other modeling approaches, the simulation model is implemented in the software AnyLogic 8. The software supports a combination of DES and ABS. The model can also be animated in 2D/3D, allowing concepts and ideas to be more easily verified, communicated, and understand.
To make the model conform to the actual hospital situation, it is assumed that patients start to queue at 7:00 am at the registration center of the healthcare facility. When the registration center can be available at 8:00 am, the patients can go through the relevant treatment process. For patients registered on the spot, if they wait to see the doctor for more than 3 hours, they will temporarily leave the hospital.
For healthcare facilities planning, different designs can be tested with simulation software before the documentation for construction. This study shows that simulation models can be useful decision-support tools for healthcare facilities management.