Modelling radiology department operation using discrete event simulation

Recent policy announcements by Australian government departments suggest a need to explore the use of process management principles, normally applied to manufacturing industry, to healthcare services management. The research presented in this paper is part of a broader project that uses discrete event simulation coupled with visual display of results to reduce patient flow in hospital emergency departments (EDs). It is conjectured that such visual approaches will enable clinicians to better understand the simulation models and plan for work process improvements. Given its relationship to the ED, this paper focuses on patient flow in a radiology department. The paper summarises current scheduling practices in one Australian public hospital and provides a basis for future investigation of strategies to improve resource utilisation and average patient wait-times. Key parameters of current scheduling practices such as equipment and human resource availability, booking timeslot duration and patient mix are also identified for the purpose of visually simulating patient flow within the imaging department and optimising patient scheduling. To ensure the models accurately reflected hospital process, primary and secondary data were collected. Primary data were sourced from observations of work flow, patient flow, and departmental practices; these observations were then validated through interviews with hospital staff. Secondary data were sourced from hospital records and included information on the sonography department - more specifically, its patient case-mix, its activity level, patient bookings and schedules, staff rosters, and award constraints. These data spanned a period of three months. Using the collected data, a simulation model was built to illustrate current departmental processes to hospital staff, and identify areas for improvement. This was achieved using Tecnomatix Plant Simulation® software. The visual nature of the program helped staff to readily understand the complex relationship between hospital departments, and examine feasible strategies such as increasing staff resources and/or altering booking timeslot duration to enhance patient flow. Simulation has been used as a method of providing hospitals with an objective and a justifiable basis for proposing and making change. This was duly indicated by hospital staff who proceeded to use the models to inform decisions about ways to improve the operation of the radiology and emergency departments. Future research is needed to evaluate the implementation of simulated solutions, as this would help to validate the use of discrete event simulation in health services management research.