Master of Science (MS), Ohio University, 2020, Industrial and Systems Engineering (Engineering and Technology)

Process improvements in hospitals usually focus on a single department (eg. emergency department, operating theater, specialty clinic, etc). However, actions taken in one department inevitably affect the performance of other departments. Therefore, higher efficiency improvements can be obtained by considering the patient care process as one synergetic activity involving several departments and various sets of resources. In this research we propose an integrated approach for modeling the patient lifecycle for multiple departments. First we describe a patient flow from his/her entry into the hospital through a progressive care unit until the patient has fully recovered. We use process mapping methods to address value added activities and other necessary activities in the patient lifecycle. Then, a simulation model is developed in Simio using customized objects created in previous works. Those customized objects carry their own logic and behavior. For example, the Bed object includes logic for a patient recovering while using several hospital resources (nurses, therapist) in his/her hospital stay. Those objects were used to build several configurations of an integrated model with multiple departments. Data about patient arrival patterns, their health acuity, and procedure needs were obtained from a real hospital in order to test our approach. The procedures duration data (which were different for different levels of patient acuity and for different surgical and other procedures) were used to obtain service distribution using statistical analysis methods. Modular simulation objects and data distributions from real hospitals allowed us to build an integrated simulation model with several configurations of the process flow. Simulation experiments were performed on these models and performance recorded. The recommendation for implementations in the hospitals is also reported.

Committee: Dusan Sormaz (Advisor); Gursel Suer (Committee Member); Diana Schwerha (Committee Member); Vic Matta (Committee Member) Subjects: Engineering; Health Care; Industrial Engineering

Master of Science (MS), Ohio University, 2023, Industrial and Systems Engineering (Engineering and Technology)

Using computer simulation in healthcare is a longstanding endeavor, where alternative scenarios and system configurations can be tested before they are implemented in the real world. One facet of healthcare that has an apparent lack of simulation work is that of emergency transportation, especially that which has a goal to reduce the amount of time a crew works over their designated shift. In collaboration with a Midwest USA Hospital, the researcher sought to model the current system, then experiment by altering crew schedule start times, the number of crews, and policy to reduce the frequency and duration a crew works past their scheduled end time. Therefrom, a framework was developed to help other institutions with similar aims. After the simulation model was verified and validated, experiments varying the start times of the crews, scheduling the crew constituent resources separately, and the number of crews were investigated. With the goal to reduce the time a crew spends working past their scheduled shift without negatively affecting productivity, scenarios that performed similarly in the number of transport requests serviced where there was a decrease in over-shift metrics were identified. The results of the simulation experimentation can be summarized this way: reducing over-shift comes at a cost, likely, either a reduction in productivity or an additional crew. A seven-themed framework for future studies was derived: a sound mission, system understanding, data availability/understanding, respect for process, simulation experience, results analysis and recommendations, and empathy.

Committee: Tao Yuan (Advisor); Dušan Šormaz (Advisor) Subjects: Health Care; Industrial Engineering; Management