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Abstract
In order to address certain operational questions for a hospital, Vancouver Coastal Health built a simulation model that captures the flow of all patients from multiple arrival streams all the way to discharge. For this model, historical data was analyzed to determine arrival rates, transfer rates between units, and processing times within each area of the hospital. Different patient types were created to represent the different needs and journeys of patients through the hospital. The actual inpatient bed capacities and operating room schedules were used, and additional process logic was created to simulate certain system dynamics such as surgical cancellations and the use of overflow capacity. This model helped address questions such as the impact of implementing protected surgical beds and discharging additional patients from certain units.
Keywords
Healthcare Systems, Discrete Event Simulation, Optimization, Resource Planning & Scheduling
1.Background
Similar to many OECD countries, the Canadian healthcare system faces the challenge of improving care while battling the increasing demands and costs associated with the aging population, new medical technologies, HR expenditures, etc. The Canadian healthcare authorities promote innovation to improve sustainability of the healthcare system.
Vancouver Coastal Health (VCH) is one of the five regional health authorities in the province of British Columbia. VCH operates the publicly funded healthcare systems in the cities of Vancouver, Richmond, North Vancouver, etc., covering a total population of over 1 million. Across the healthcare continuum, acute facilities or the hospitals bear the highest costs. The number of funded beds in the VCH hospitals has remained largely unchanged in the past 15 years. The hospitals are under constant pressure to serve the increasing demand using existing acute beds, and the fixed funding associated with the beds. Access and flow therefore becomes the top operational challenges that VCH hospitals face. Since 2015, the VCH Senior Executive Team introduced the concept of "Bed Gap" to operational management in order to raise awareness of the gap between fixed acute capacity and the demand on acute beds that are over the capacity, and the demand is increasing over time.
Lions Gate Hospital (LGH) is located in the city of North Vancouver. It is an acute site consisting of an Emergency Department (ED), Operation Rooms (OR), medical, surgical, maternity, cardiac, neurological, acute rehabilitation,...