Discrete event simulation model for the analysis of centralized front office service in a regional hub hospital

Abstract

Today, hospital rankings are based primarily on basic clinical indicators. The aim of the project shown in this article is to develop a methodology able to improve non-clinical front office operation for the patients (like booking exams, delivering medical reports etc.), keeping the costs under control. The service center serves 600 users every day and it is the core of a great reorganization process, focused on centralization of office activities of the Careggi University Hospital of Florence, to ensure the best services to patients. For this reason, Discrete Event Simulation model (DES) have been used. The project of the model was made according to the real process observed during the confrontation with staff, document verification, field observation stage and study of data stored in hospital’s databases. These researches provided parameters necessary for model running, such as number of accesses, service time, available resources and patient’s waiting time. Validation confirmed that model is formally correct, and shown that waiting time of patients is substantially equal between real data and simulated outputs. The mean waiting time of all patients calculated by the model (7 min and 9 s) is only 2.6% lesser than real one (7 min and 20 s). Weekly workload of the model (3048 patients) is equal to reality, proving that the schedules of patient’s accesses are correct. We used a statistic test to confirm the results. This paper shows that DES is a valuable tool that can be used to save money and improve clinical processes. In the future this model will be used to evaluate the reorganization of the Service Center with the aim to allow everyone (not only technical staff) to use it, through a web-based support, a predictive machine and a user interface.