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Simulation in Healthcare

Simulation in Healthcare. 1. 2. Jonathan Atzmon, ISE/ETM Dr. Joan Burtner, Advisor Last Revised 03/03/15. Background. Modeling and simulation (M&S) allows for the evaluation of process improvement activities Variety of applications of M&S History of M&S Arena expands the M&S market.

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Simulation in Healthcare

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  1. Simulation in Healthcare 1 2 Jonathan Atzmon, ISE/ETM Dr. Joan Burtner, Advisor Last Revised 03/03/15 Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  2. Background • Modeling and simulation (M&S) allows for the evaluation of process improvement activities • Variety of applications of M&S • History of M&S • Arena expands the M&S market Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  3. Summary of Research • A Review of the Literature Concerning Queuing Theory • A Review of the Literature Concerning Modeling and Simulation • Process Improvement Using Arena Simulation Software • Discrete Event Simulation for Healthcare Organizations: A Tool for Decision Making • A Guide for Building Hospital Simulation Models • Study on the Effect of Different Arrival Patterns on an Emergency Department’s Capacity Using Discrete Event Simulation • Emergency Department Simulation and Determination of Optimal Attending Physician Staffing Schedules • Designed to Fail: How Computer Simulation Can Detect Fundamental Flaws in Clinic Flow • A Simulation Model of a Hospital’s Clinical Laboratory • Using Queuing Theory and Simulation Model to Optimize Hospital Pharmacy Performance Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  4. General Arena (version 14.5) Model Home Screen Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  5. General Arena (version 14.5) Model Default Menu Bar & Toolbar Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  6. General Arena (version 14.5) Model Flowchart of the General Model Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  7. General Arena (version 14.5) Model Create Module • Located in the Basic Process template panel • Create Module • Generates entities that flow through the model • Name = Entities Arrive to Process • Entity Type = Entity • Type of Time Between Arrivals = Schedule • Schedule Name = Arrival Schedule • Schedule Module • (Arrival Rate, Duration) = (40, 1); (35, 1); (25, 2); (0, 1); (35, 1); (25, 2); and (35, 1) Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  8. General Arena (version 14.5) Model Process Module • Located in the Basic Process template panel • Simulates an amount of time for an entity to perform or undergo some type of procedure • Name = Process • Logic • Action = Seize Delay Release • Resources • Type = Resource • Resource Name = Process Resource • Quantity = 1 • Delay Type = Triangular • Units = Minutes • Minimum = 1 • Value (Most Likely) = 2 • Maximum = 3 Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  9. General Arena (version 14.5) Model Variable & Failures • Variable • Placed above the Process module • Indicates the current number of entities in the queue waiting to be processed by the Process Resource • Failures • File/Template Panel/Advanced Process • Allows for the simulation of resource downtime • Resource Module • Failure Name = Resource Failure • Failure Rule = Preempt • Failures Module • Type = Time • Up Time = 4 hours • Down Time = 1 hour Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  10. General Arena (version 14.5) Model Decide Module • Located in the Basic Process template panel • Simulates decision-making based on chance or a condition • Name = Decide • Type = 2-way by Chance • Percent True (0 – 100) = 15 Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  11. General Arena (version 14.5) Model Dispose Module • Located in the Basic Process template panel • Removes entities from the model • Records entity statistics for the report • Name = Entities Depart Process Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  12. General Arena (version 14.5) Model Record Module • Located in the Basic Process template panel • Name = Record # of Entities Sent to True Node • Type = Count • Value = 1 • Counter Name = # of Times Entities Sent to True Node Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  13. General Arena (version 14.5) Model Assign Module • Located in the Basic Process template panel • Name = Change Entity Picture • Assignment • Type = Entity Picture • Picture.Box Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  14. General Arena (version 14.5) Model Plot of the Measure of Interest • Data Series tab/Add button • Series 1 Properties/Source Data/Expression • Basic Process Variables/Queue/Current Number in Queue • Axes tab • Maximum value of the Time (X) Axis = 540 • MajorIncrement value of the Time (X) Axis = 60 • Maximum value of the Left Value (Y) Axis = 40 • AutoScaleMaximum = False • Titles tab • Header’s Text = Number in Process Queue • Legend tab • Uncheck the Show Legend menu option Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  15. General Arena (version 14.5) Model Running the Model • Run/Setup • Project Parameters • Project Title • Analyst Name • Statistics Collection • Reports • Category Overview • Replication Parameters • Replication Length • Base Time Units • Number of Replications • Run/Check Model • Play button Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  16. Arena’s Input and Output Analyzer Reduction of the Queue Length • Scenario 1 – Base Scenario • No changes to general model previously defined • Scenario 2 – Probability Distribution of the Process • Use Arena’s Input Analyzer to develop a probability distribution of the Process delay • Data file in the format Formatted Text (Space Delimited) • File/New • File/Data File/Use Existing • Fit/Fit All • Weibull distribution with scale parameters (β, α) = (0.734, 0.795) • Scenario 3 – Increased Capacity of the Resource • In the Resource module, change the capacity of the Process Resource from one to two Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  17. Arena’s Input and Output Analyzer Reduction of the Queue Length (Continued) • Number of Replications = 100 • Statistic module • Name = # Entities in Process Queue • Type = Output • Expression = NQ(Process.Queue) • Report Label = # Entities in Process Queue • Output File = scenario# • For # is 1, 2, or 3 Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  18. Arena’s Input and Output Analyzer Reduction of the Queue Length (Continued) • One-Way Analysis of Variance (ANOVA) • Objective = Determine which scenario resulted in the smallest number of entities in the Process queue • Procedures • Arena’s Output Analyzer/Analyze/One-Way ANOVA • Add the three data files (one for each scenario) with the replications lumped • Comparison Method = Tukey • Confidence Level = 0.95 Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  19. Arena’s Input and Output Analyzer Reduction of the Queue Length (Continued) • One-Way Analysis of Variance (ANOVA) • Purpose = Compare the mean number of entities in the Process queue for each of the three scenarios • Hypotheses • H_0: μ_1 = μ_2 = μ_3 • H_1: At least one scenario differed in the mean number of entities in the Process queue Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  20. Arena’s Input and Output Analyzer Reduction of the Queue Length (Continued) • One-Way Analysis of Variance (ANOVA) • Results Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  21. Research Opportunities • Business, industry, education, healthcare, and government • Process Improvement Tools • One-Way ANOVA • Control Charts • Check Sheets • Pareto Charts • Cause-and-Effect Diagrams • Defect Concentration Diagrams • Scatter Plots Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

  22. Further Opportunities • Resources • Courses: ISE 403 – Modeling and Simulation; ETM 607 – Modeling and Simulation • Dr. Scott Schultz; Dr. Pablo Biswas • YouTube • Other Applications • Fit a statistical distribution to a data set using Arena’s Input Analyzer • Other modeling capabilities such as forklifts and conveyor belts • Reminder = ONE directory folder per project Atzmon ETM 691.001, Simulation in Healthcare, Spring 2015, Dr. Joan Burtner

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