OBJECTIVES: To determine the optimal capacity and workflow processes of the Outpatient Surgery Center (OSC) for a rural hospital based on the future demand, redesigned care processes, and current available technologies using the Discrete Event Simulation (DES) method. METHODS: Planning for health care delivery services is extremely complex due to the involvement and interactions of people, facility, process, and technology. Making data-driven decisions, while customizing care to the needs of individual patients and family, is critical to efficiently delivering patientcentered care. We employed the Discrete Event Simulation (DES) method to optimize the future bed capacity based on the projected demands. Workflow improvements, that were necessary to meet efficiency optimization and desired patient experience for future success of the OSC, were also identified. The planning team developed a future state floor plan that met the needs of the patients and staff based on a set of assumptions. Locations of rooms, resources, and optimal workflows were determined through data collected from observations and time studies of outpatient surgery holding rooms, treatment rooms, and operating rooms. Patient tracks were modeled within the simulation from the collected data which generated a real-world view of patient flow through the system. RESULTS: The simulation allowed for the utilization of current time study data to determine how changes impacted the future output metrics and care processes using a new floor plan. By running the simulations with an improved room turnover process and an increased patient volume, it was concluded that the optimal number of outpatient surgery beds was 17 instead of the 22 beds that were recommended by the marketing and planning department. CONCLUSIONS: The optimal bed capacity allows for potential future growth and would maximize room utilization by limiting the number of idle rooms (idle rooms waste healthcare resources) while providing the best patient experience.
Wong, P., Sommer, M., & Buhs, A. (2015). How many Outpatient Surgery beds do we need? Value in Health, 18(3), A92. https://doi.org/10.1016/j.jval.2015.03.537