Constructing holistic patient flow simulation using system approach

Abstract

Patient flow often described as a systemic issue requiring a systemic approach because hospital is a collection of highly dynamic, interconnected, complex, ad hoc and multi-disciplinary sub-processes. However, studies on holistic patient flow simulation following system approach are limited and/or poorly understood. Several researchers have been investigating single departments such as ambulatory care unit, Intensive Care Unit (ICU), emergency department, surgery department or patients’ interaction with limited resources such as doctor, endoscopy or bed, independently. Hence, this article demonstrates how to achieve system approach in constructing holistic patient flow simulation, while maintaining the balance between the complexity and the simplicity of the model. To this end, system approach, network analysis and discrete event simulation (DES) were employed. The most important departments in the diagnosis and treatment process are identified by analyzing network of hospital departments. Holistic patient flow simulation is constructed using DES following system approach. Case studies are conducted and the results illustrate that healthcare systems must be modeled and investigated as a complex and interconnected system so that the real impact of changes on the entire system or parts of the system could be observed at strategic as well as operational levels.