Operations Improvement

Modeling the flow of emergency-origin patients to reduce the paramedic-patient diversion rate in an urban hospital.

The scope of this simulation model included arrival rates (by time of day and by day of week) at various key points of patient entry to the hospital as well as service delivery rates to see where backlogs occurred, under what conditions, and to test ideas for improving patient flow. The client team learned that a number of its prior ideas for improvement would have no appreciable effect on performance (or, unintentionally, would worsen performance), and they learned the few interventions that would establish balance within the system. After implementation, this hospital reduced its paramedic patient diversion rate from 35% to less than 5% with no new operating or capital expense.

Facility Master Planning Integrated with Strategy and Finance Planning

Modeling alternatives for major capital investment to support a healthcare facility master planning process integrated with strategic and finance planning.

The scope of this model included alternative future market scenarios, population, inpatient and outpatient demand, capacity and condition of multiple facilities, and financial condition. It enabled leaders at a large, urban hospitalÑwith major commitments to teaching and research in addition to patient careÑto examine alternative uses of limited capital resources and to gain insight about their optimal deployment in a turbulent environment. Among the results of this work included a fundamental change in both mindset and direction about long-range facility plans and an alignment of diverse stakeholders around the changed direction.

Redesigning Administrative Processes

Modeling the redesign of administrative processes associated with hospital-based inpatient and outpatient care.

This hospital was undertaking a large initiative to redesign the processes that support patient care in the admitting function, medical records processing, the discharge planning function, billing and receivables management. We supported this effort by using simulation to both establish the as-is condition and test alternatives for process redesign. Goals of the redesign, for which our simulation measured performance, include elimination of backlogs, reduced overall length of stay, improved recovery of charges, and operating expense reduction. In less than one year following this work, the hospital implemented a set of recommended improvements and realized a savings of more than $1.8 million in annual operating expense as a direct result.

Organizational Learning

Creating a Learning Lab for broad organizational learning about successfully managing healthcare delivery in a changing and competitive environment.

This large, integrated, healthcare delivery system had been successful for years, but was beginning to experience financial performance declines. Its large size and dominant market position tended to insulate clinical and administrative staff at multiple local service sites, leading to slow reaction times at a time when the pace of change in the marketplace was accelerating. We created a simulation model in Learning Lab formatÑa tool that was game-like for easy user interaction and a curriculum for its use that would engage leaders and staff throughout the organization. Offering staff the hands-on experience of managing their organization in a changing marketplace, the Learning Lab has been used by hundreds of staff in mixed groups, stimulating dialogue and thoughtful policy change in workshops which participants consistently rate as superior to other educational retreat experiences.