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 in Industrial Engineering, University of Toledo, 2008, Industrial Engineering

Six Sigma is a comprehensive and flexible system for achieving, sustaining andmaximizing business success. It strives to improve quality, productivity, and bottom line success using statistical tools. Six Sigma's methodology consists of five phases: Define, Measure, Analyze, Improve, and Control (DMAIC). In manufacturing, Six Sigma has been used extensively with great success. The application of Six Sigma to the healthcare field is in its early stages and, hence, has not been fully explored. This research investigated the use of Six Sigma with the goal of improving the renal implant process and demonstrating the positive impact of Six Sigma on the healthcare industry. The objective of the research was to improve the process for renal transplants at The University of Toledo Medical Center utilizing Six Sigma. This included aligning and optimizing processes and the removal of process-generated defects and errors. Improvements will primarily focus on: optimizing cycle times, enhancing customer satisfaction, improving efficiencies, reducing costs, streamlining administrative processes, elimination of errors, and improving protocol execution and effectiveness. This research identified ten improvements which could be applied to the renal transplant process. Implementing improvements could reduce the total process time by 45 days (20%) from 227 days to 182 days, and could also improve productivity, communication, and customer satisfaction.

Committee: Steven Kramer PhD (Advisor); Matthew Franchetti PhD (Other); Afjeh Abdollah PhD (Committee Member) Subjects: Engineering; Health Care