• Increasing Efficiency while Minimizing Risk Powered By Dynamic Simulation and Live Tracking

    by
    Hosni
    Published on 05-03-2011 07:57 PM

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    Agenda
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    Operational Quality
    Operational Quality Relates to every aspect of the organization and defines the level of interaction and harmony among processes.
    •  Effect of Operational Quality on the Organization
      A low OQ in bed allocation can create problems in the ED area rendering the ED incapable of operating effectively.

    •  Managing OQ in healthcare poses additional challenges due the highly interactive and variable nature of the process chain.
    Measuring Operational Quality
    •  Efficiency is the key measure for Operational Quality. An efficient organization indicates that
      • 1. Processes interact effectively.
      • 2. Communication is well defined.
      • 3. Customers enjoy a positive experience.
      • 4. Picking/Receiving/Put away/Replenishment are coherent.
      • 5. High profitability.
    •  Lean Concepts applications
      • • Lean Concepts normally measure process level efficiency with minimal impact on global efficiency.
      • • Improving efficiency in one area should not impact negatively the overall measure, and any change effect should be analyzed throughout the process sequence.
       
    Measuring Efficiency
    •  Patient perspective, Efficiency is the ratio of
      Total Time Receiving Care/ Length of Stay
      • • If care is provided as soon as the patient is ready, and the quality of care does not decline, the operation would be highly efficient.

    •  Provider perspective, Efficiency is
      Total Time Providing Care / Shift Duration.
      • • Applies to individuals, departments, labs, etc.

    •  Management perspective, Efficiency is measured as the combination of both;
      • • An efficient provider base combined with expedient quality care generates the most efficient operation.
    Measuring Provider Efficiency
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    Healthcare Challenges
    •  Challenges to improving efficiency in healthcare systems
      • • Area demographic and seasonality.
      • • Managing the unexpected.

    •  Lack of defined time standards.
      • • Every patient requires a different “time of care” even with similar symptoms.

    •  External factors
      • • H1N1, outbreaks, disasters, …
    Solution Requirement
    •  Must be able to Visualize and Analyze the current operation.
      • • Analysis is used to identify areas of maximum impact (best ROI).
      • • Visualization communicates and conveys the benefits of the analysis.
    •  Data Availability
      • • Analysis must be performed based on accurate data representation.
      • • Distribution based analysis suffers from large approximation.
        • ° Provides a global direction and not actual improvement.
      • • Real Data provides accurate representation, with variability implemented as a distribution.
    •  Human Capital — Leverage available talent, gain buy-in.
       
    Options
    •  Traditional Approach


    •  Dynamic Simulation


    •  Dynamic Analysis and Live Tracking
    Traditional Approach
    •  Spreadsheet based analysis
      • • Limited, does not factor time into analysis.
      • • Overly complex.
    •  Traditional Simulation Tools
      • • Code heavy environment.
      • • Often fail to complete.
      • • “Expert” required to perform any analysis.
    •  Physical Simulations
       
    Dynamic Simulation
    •  Dynamic Simulation uses interactive on-the-fly technology;
      • • Enables any member of the team to experiment and provide new ideas.
      • • Highly visual, and interactive environment.
      • • Enables creativity and ownership of new solutions.
      • • Data analysis is simplified to be useful to non-statisticians.

    •  Dynamic Simulation provides the required statistical views to compare and analyze improvement and effect of change.

    •  Dynamic Simulation can connect to live data streams.
     
    Dynamic Simulation
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    Dynamic Analysis and Live Tracking
    •  Dynamic Simulation & Connectivity to live data
      • • Connect to EMR Systems.
      • • Connect to RFID systems.
        • ° Equipment RFID tracking can be visualized / analyzed in real time.
        • ° Connectivity to HR systems.
      • • Connectivity to Barcode systems.

    •  Drives the Continuous Improvement Principle and enables organizations to be proactive in OQ monitoring.
    Tracking Technologies
    •  Barcode
      • • Simple, cheap, and proven technology.
      • • Requires man power and is prone to error (missed scans).

    •  Active RFID
      • • Battery powered devices sending signals at different intervals.
      • • Expensive, technology is not yet suitable for tracking
        • ° Positioning is area based, 15ft radius is standard.
        • ° Interference and infrastructure requirements.
       
    Tracking Technologies (2)
    •  Passive RFID tags
      • • Relatively inexpensive, proven technology used effectively in different industries.
      • • Fast forward/Rewind — DVR like controls.
      • • Requires either scanners or specialized antennas.
      • • Can be accurate to a foot.

    •  EMR data
      • • EMR contains patient, and provider positioning data, provided that it is properly used.

    •  Simple connectivity (Read Only) and accurate data.
    Tracking Providers
    •  Benefits of tracking providers
      • • Improved visibility. The problems could be related to the tasks assigned or distance travelled.
      • • Improved and more complete data analysis.
      • • Better scheduling capability.
    Provider tracking may be performed in phases. Some resistance may be encountered.
       
    Value of Replay with Analysis
    •  Replay provides a functionality to visually review old data.
      • • Play the data like a DVR, rewind, forward or replay a specific moment in time.

      •  During replay, the model can be switched to simulation mode
      • • All collected data is imported in the model — no need for extensive time studies.

       Play what if scenarios on the model, analyze improvements, and create “Things to Avoid” processes.
    Dynamic Resource Allocation
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    Supply Chain Support
    •  The tracked data is used to identify supply chain patterns and replenishment requirements within the hospital.

      • • Based on the EMR data, the store content, historical performances and forecasted values, an accurate replenishment request can be automatically triggered.
      • • Replay with Analysis can also be used to optimize supply chain paths, replenishment quantities, and other factors.
    Live Tracking
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    Remote Monitoring
    •  Remote monitoring is achieved by
      • • Monitoring individual departments.
      • • Monitor the overall operation.

    •  With internet connectivity, remote monitoring can be performed through secure connections to the internal network.
    Proactive OQ Monitoring
    •  Real-Time Visibility and Remote Monitoring.
    •  Proactive Analysis and Forecasting
      • • Predict potential OQ issues before they occur.
      • • Dynamic Staffing management.
      • • Proactive Scheduling.
    •  Replay with Analysis
      • • Visually replay the past, analyze inefficiencies and provide recommendations.
    •  Automated Alerts
       

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