MelModel Solutions Help Support Patients by Tracking Their Progress
Written by Noah Tolson, Array Architects
Discrete Event Simulation: Enhancing Flow in Healthcare Design
Discrete Event Simulation (DES), which has been utilized across industries for several decades, provides a virtual environment to track and visualize patients, equipment and providers as they move through the steps of care. It is an important tool in supporting Lean Design in the healthcare environment.
In order to achieve the desired physical environment, healthcare architects rely on a vast amount of data – and the tools for harnessing that data are becoming more advanced. Just as BIM optimizes early decision-making in the design phase, so to can Discrete Event Simulation (DES) influence the design of workflow and patient flow prior to construction.
At Array, we have found that this virtual environment gives us the ability to test a multitude of ‘what if’ scenarios with our clients to understand the impact that different layouts have on workflow, patient flow and resource utilization. The result is an increased confidence that the design will support current needs, as well as provide insight on incorporating flexibility into the design to accommodate the inevitable changes that will come in the future.
There are three key advantages DES provides over other methods of analysis:
1) Real live variability can be applied to a critical key measurements such as: patient demand, times to complete key tasks, wait times for key resources or simply waiting for care, etc.
2) Naturally occurring constraints exist when the demand for services/resources exceeds capacity. DES models allow constraints to be included by identifying the interdependencies between resources available and resources required.
3) DES models simulate the passing of time (into the future) and record key metrics such as wait times, processing times, resource utilization and equipment utilization as they relate to varying patient demand and varying patient acuity. This helps with the daunting task of attempting to predict when the care is to be provided and by whom.
Utilizing Lean Design, architectural teams appropriately spend time observing and recording work flow and patient flow to document and understand the current state. Accurately predicting the future state work flow and patient flow has always been difficult to project and arrive at consensus because workflow analysis has traditionally been based on averages. While averages are a good place to start, they don’t tell the entire story. This is where DES, due to the advantages described above, is highly valuable. Using a DES tool like ProModel’s MedModel, Process Simulator or Patient Flow Simulator to model the various hospital processes in the new structure, we can provide much more insight into the effectiveness of potential designs. DES helps evaluate the workflow, resources and patient demand more realistically and simultaneously which allows healthcare decision-makers to be more confident in the design solutions.
MedModel was recently used to help one healthcare organization evaluate a newly constructed 220,000 SF outpatient facility. The facility was intended to centralize the services of affiliated specialty practices and education & research centers. This five-floor clinic would allow 65 providers from 13 different practices throughout a specific region to converge in one patient-friendly location. Quality and service was expected to increase greatly by having referring physicians in one collaborative environment. Spreadsheet models were initially used to study the consolidation and facility design project, but provided only static information that relied heavily on the use of averages. This made it hard to accurately study the many complex processes that occur continuously in an outpatient setting. With the limited data available, physicians and administration had difficulty reaching consensus on space requirements and efficient room utilization. At issue, could the newly consolidated practices operate comfortably on the first and third floors, or did they need additional space? A MedModel solution proposed first and third floor designs of the clinic in order to analyze capacity and resources against the current data on patient flow from all the converging practices. The simulation examined the individual practices over a five day period (Monday through Friday) during regular business hours. The measuring criteria consisted of the following:
· Exam room utilization
· Physician and staff utilization
· Number of patients in check-in
· Time spent in check-in queue
· Patient activity times
· Number of patients in Imaging queue
After multiple scenarios were run, the output data confirmed there would be sufficient room for the consolidation of practices on the first and third floors. In fact, the analysis showed that on certain days of the week there were not enough providers to fill the capacity on those two floors.
This is one example that illustrated the advantages of DES. Array and ProModel have used similar methods to more accurately project operational outcomes and compare design solutions.
About the Author
Jim Cain and co-author Noah Tolson, AIA, LEED AP; Practice Area Leader for Planning, Array Architects ([email protected]) and Jim Cain, MSN, Director of Healthcare Solutions, ProModel Corporation.
Skin Analytics wins NHSX award for AI skin cancer tool
An artificial intelligence-driven tool that identifies skin cancers has received an award from NHSX, the NHS England and Department of Health and Social Care's initiative to bring technology into the UK's national health system.
NHSX has granted the Artificial Intelligence in Health and Care Award to DERM, an AI solution that can identify 11 types of skin lesion.
Developed by Skin Analytics, DERM analyses images of skin lesions using algorithms. Within primary care, Skin Analytics will be used as an additional tool to help doctors with their decision making.
In secondary care, it enables AI telehealth hubs to support dermatologists with triage, directing patients to the right next step. This will help speed up diagnosis, and patients with benign skin lesions can be identified earlier, redirecting them away from dermatology departments that are at full capacity due to the COVID-19 backlog.
Cancer Research has called the impact of the pandemic on cancer services "devastating", with a 42% drop in the number of people starting cancer treatment after screening.
DERM is already in use at University Hospitals Birmingham and Mid and South Essex Health & Care Partnership, where it has led to a significant reduction in unnecessary referrals to hospital.
Now NHSX have granted it the Phase 4 AI in Health and Care Award, making DERM available to clinicians across the country. Overall this award makes £140 million available over four years to accelerate the use of artificial intelligence technologies which meet the aims of the NHS Long Term Plan.
Dr Lucy Thomas, Consultant Dermatologist at Chelsea & Westminster Hospital, said: “Skin Analytics’ receipt of this award is great news for the NHS and dermatology departments. It will allow us to gather real-world data to demonstrate the benefits of AI on patient pathways and workforce challenges.
"Like many services, dermatology has severe backlogs due to the COVID-19 pandemic. This award couldn't have come at a better time to aid recovery and give us more time with the patients most in need of our help.”