3 Presentations

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  01:30 PM - 02:00 PM

  Whole-System Patient Flow Simulation Model Applied to Stroke Best Practices Evaluation

  • Ali Vahit Esensoy, presenter, University of Toronto
  • Michael Carter, University of Toronto

  Cross-sector patient flow model is a system dynamics simulation focused on the flow rates of patients between health system sectors, and the feedback structures around them. It takes a whole-system, strategic perspective, and is designed to produce output that captures the direction and magnitude resulting from policy changes around patient pathways and service levels. We discuss our development process, highlighting the power of using multiple simple models in combination with patient-level data. We will demonstrate the model’s use in policy analysis through the evaluation of the impact of Ontario’s proposed stroke best practices.

• 
  02:00 PM - 02:30 PM

  Finding a scheme to maximize physicians' satisfaction while minimizing patients' pre-treatment phase

  • Nazgol Niroumandrad, presenter, Polytechnique Montreal
  • Nadia Lahrichi, Polytechnique Montréal

  A medical procedure to a patient often includes sequences of tasks performed by different individuals. Each task is in combination with equipment, supplies and specialized staff. At each step of care, waiting may be needed, which is a challenge to ensure that patient flow will be smooth from one step to the next.
  Due to insufficient supply and high demand, many patients experience delays in receiving treatment. Minimizing the waiting time for each stage of treatment for patient, achieving a high level of synchronization among patients, staff and resources which ensures that the services can be provided as the arrival of the patient, are some key goals that should be considered in an efficient management system.
  In cancer facilities and radiotherapy centers, time plays a significant role. The sooner the decease is recognized and treatment is started, the chance of success in treatment is higher. Thus, there is not much time to waste in the pre-treatment phase. We would like to shorten this phase and make the patient ready to start the treatment in a week.
  In a hospital, one of the most vital and major resources is the staff. Since physicians play a significant role in providing healthcare services for patients, considerable time consuming can be obtained by focusing on physicians scheduling.
  The objective of this study is determining a task schedule for physicians in order to increase their satisfaction/preferences while improving the patient flow and decreasing patients pretreatment phase in a radiotherapy center with considering all possible constraints. To reach this objective, we developed an Integer Linear Programming which was a pattern based. In addition, a meta-heuristic approach (Tabu Search) was developed based on physicians’ tasks to evaluate the quality of patterns.

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  02:30 PM - 03:00 PM

  Modelling the Benefits of Radiographer Led Discharge

  • Sebastian Rachuba, presenter, University of Exeter
  • Martin Pitt, University of Exeter
  • Karen Knapp, University of Exeter

  Diagnostic imaging services are an essential part of the diagnosis pathway for many patients arriving at hospital emergency departments. Commonly, patients need to be seen again by a doctor or emergency nurse practitioner after radiographic imaging has been conducted to finalise their diagnosis and determine the next stage in their pathway (e.g. admission to hospital, fracture clinic or discharge). Depending on the workload of the doctors and the general activity levels the emergency department, significant waiting times can accrue for this follow-up consultation following imaging. There is evidence that a significant number of patients with appendicular injuries could be discharged by the radiographer directly after imaging, without the need to be seen again by a doctor if no fracture is detected. This could potentially both reduce load on the emergency department and also lessen wait times for patients. Dedicated training for radiographers to improve image interpretation skills could therefore enable earlier discharge for a significant proportion of patients with specific diagnoses. In this study, we model patient pathways through a hospital’s accident and emergency department in order to analyse current practice and the resulting wait times and workload. In terms of a what-if analysis we evaluate the possible impact of introducing early discharge by radiographers directly after imaging. Based on a conceptual model we build up a simulation model which has been developed in order to evaluate current practice at a hospital in the SW of the UK. We conduct a simulation study using Simul8 and demonstrate the benefits of a radiographer led discharge in terms of changes in consultants' workloads and reduced waiting times.