Author Archives: russellmod

ProModel Solutions Presented at the 2015 Patient Flow Summit

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In May ProModel joined a diverse and talented group of healthcare professionals in Las Vegas to share best practices for improving process and positively impacting the quality of patient care.  Presenters provided views on a wide variety of patient flow issues including population health management, RTLS systems, healthcare reform, readmissions, surgical variability and ED processes.

Not only did ProModel have an exhibit at the event where we were able to officially unveil our new Patient Flow RX solution, but we were also very lucky to have ProModel client and user David Fernandez MHA there to give an insightful and informative presentation on his successful use of simulation in the healthcare world.  Fernandez is VP of Cancer Hospital, Neuroscience and Perioperative Services at Robert Wood Johnson University Hospital and his presentation “Let My Patients Flow! Streamlining the OR Suite” described his use of lean management principles and simulation modeling to improve patient flow in the OR.

David Fernandez MHA, Robert Wood Johnson University Hospital discusses his use of simulation for improving patient flow in the OR

David Fernandez MHA, Robert Wood Johnson University Hospital discusses his use of simulation for improving patient flow in the OR

Among numerous other presentations, keynote speaker Eugene Litvak PhD, President & CEO of Institute for Healthcare Optimization was there to address the application of queuing theory to healthcare processes, as he believes it is a methodology that will correctly address the challenge of hospitals to match random patient demand to fixed capacity.

The Patient Flow Summit helped hospital leaders from all over the world learn the latest about optimizing capacity, streamlining operations, improving patient care, and increasing fiscal performance.

Presenters provided views on a wide variety of patient flow issues

Presenters provided views on a wide variety of patient flow issues

ProModels (L) Kurt Shampine, VP and (R) Dan Hickman, CTO – unveiling Pateint Flow Rx!

ProModels (L) Kurt Shampine, VP and (R) Dan Hickman, CTO – unveiling Pateint Flow Rx!

Teaching Systems Analysis and Modeling

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ProModel Guest Blogger: Robert Loomis, Ph.D. Adjunct Professor, Florida Institute of Technology; NASA (Retired)

Loomis

Robert Loomis, Ph.D.

I teach a number of courses for the Florida Institute of Technology, one of which (Systems Analysis and Modeling) is a 17 week graduate level survey course in Systems Analysis, various types of modeling and how the modeling fits into the SA process.  This course is designed to be “a mile wide and an inch deep” in that it introduces several topics that could, by themselves, be the subject of dedicated courses.

One of the challenges in teaching a course such as this (particularly in an MBA environment) is to find tools that are effective and demonstrate the concepts well without becoming bogged down in the mechanics of the tools employed.  It also helps if the students find them engaging to use.  I ended up writing some of my own applications for certain deterministic models in order to meet those requirements and to emphasize the concepts that I felt were important.

I chose ProModel to use as a simulation package for a number of reasons. It has:

  • A graphical User Interface that is attractive, easy to use, and (at least at the level my class uses) easy to learn.
  • Outstanding documentation.
  • An excellent Professor Package.
  • An excellent Student Package. It is modestly-priced and fully-featured (limited only by the size of the model that can be created).
  • A Workstation Simulator (added by ProModel this year) that is extremely useful for instructors and students.

I have also found the ProModel staff to be responsive, courteous, and willing to help with any issues that may arise. I believe ProModel recognizes that offering an excellent value and support in the teaching environment will pay long-term dividends as the students move into their professional environment, and I applaud ProModel for their insight.

About Robert Loomis

Robert Loomis received a BSEE from Michigan State University, and an MS and Ph.D. in Industrial Engineering from Texas A&M University.  For the last 30 years he has worked for NASA and the United Space Alliance (USA) in the space and aerospace environment as a safety and reliability expert. His NASA positons included Chairman of the Kennedy Space Center (KSC) Safety Engineering Review Panel, Chairman of the KSC Ground Risk Review Panel, Manager of Data Systems at NASA Headquarters, Deputy Director of Safety at Dryden Flight Research Center (DFRC), and Head of the Independent Technical Authority at DFRC. He held numerous positions with USA, culminating in Corporate Director of Mission Assurance.  Dr. Loomis’ recognitions include the NASA QASAR Award, the NASA Exceptional Public Service Medal the Astronauts Silver Snoopy Award; the IEEE Millennium Medal; IEEE Reliability Society Lifetime Achievement Award; and Leadership and Teamwork Awards from the United Space Alliance.  He is a Senior Member of the IEEE and a Fellow of the Society of Reliability Engineers. He is an adjunct professor at Florida Tech; and most importantly, a Full-Time Grandfather to the three nicest, smartest, and best-looking grandchildren on the planet.

In the OR with Dale Schroyer

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Dale%20Schroyer

Dale Schroyer – Sr. Consultant & Project Manager

I generally find that in healthcare, WHEN something needs to happen is more important than WHAT needs to happen.  It’s a field that is rife with variation, but with simulation, I firmly believe that it can be properly managed.  Patient flow and staffing are always a top concern for hospitals, but it’s important to remember that utilization levels that are too high are just as bad as levels that are too low, and one of the benefits of simulation in healthcare is the ability to staff to demand.

Check out Dale’s work with Robert Wood Johnson University Hospital where they successfully used simulation to manage increased OR patient volume: 

About Dale

Since joining ProModel in 2000, Dale has been developing simulation models used by businesses to perform operational improvement and strategic planning. Prior to joining ProModel Dale spent seven years as a Sr. Corporate Management Engineering Consultant for Baystate Health System in Springfield, MA where he facilitated quality improvement efforts system wide including setting standards and facilitating business re-engineering teams. Earlier he worked as a Project Engineer at the Hamilton Standard Division of United Technologies.

Dale has a BS in Mechanical Engineering from the University of Michigan and a Masters of Management Science from Lesley University. He is a certified Six Sigma Green Belt and is Lean Bronze certified.

NEW! ProModel’s Patient Flow Solution:

http://patientflowstudio.com/

ProModel Healthcare Solutions:

http://www.promodel.com/Industries/Healthcare

Healthcare’s Evolution

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Jacqueline Hodge - ProModel Director of Healthcare Initiatives

Jacqueline Hodge – ProModel Director of Healthcare Initiatives

Ever heard the phrase:  “Keep doing what you’re doing and you’ll keep getting what you’re getting”?  My Mom used to say that to me all the time and I still think about it today.  I’ve been in the healthcare industry my entire life and, needless to say, a career that has never had a dull moment.  Change is the only constant in healthcare today.

 Healthcare is a place for those who don’t shy away from change and can embrace new ideas even when they are not popular.  Many of the decisions made in healthcare are based on intuition, gut feelings, experience, and consensus. I’ve been a part of those think tanks and times have changed… information resources have changed…                                                           technology has changed… expectations have changed!

Our hospitals have been tasked to do more with less – who hasn’t heard that right?  Through innovative technologies like simulation, we can use predictive analytics to visualize, analyze, and optimize processes.  We have to identify the bottlenecks in our systems that are affecting patient outcomes, patient wait times, correct bed placement and optimal staffing.  Variability in patient flow through our healthcare systems is an impediment to the cost reductions and improvement of patient safety and quality of care (Litvak et al).

Systems have been slowly adopting the principles learned through lean and six sigma but have slow to adapt to the tools available.  Hospitals have shifted from revenue generating to cost reduction.  Simulation tools are the next step in healthcare’s evolution to impact costs due to healthcare’s unique challenges caused by variability due to competition for patient beds, resources, and patient throughput — all are a part of the ongoing challenge we face to meet expectations for ‘doing more with less”

About Jacqueline Hodge

Jacqueline has had the privilege of being part of the healthcare industry for the past 25 years in Arizona after moving from Nashville, TN.  She has served in numerous roles throughout her healthcare career including medical technologist, business development executive and hospital CEO.

Prior to joining ProModel, Jacqueline was the CEO of Promise Hospital Phoenix where she provided strategic leadership to all clinical operations.  She established and executed goals that directly impacted hospital operations, patient care, physician development and business growth.  Having been a CEO, Jacqueline knows the immeasurable value that simulation technology brings to hospital operations. She was able to make leadership decisions quickly by analyzing internal data in its virtual environment with the ability to focus on both high level strategic initiatives and day to day operational tactics.

At Promise Hospital Jacqueline previously served as their VP of Business Development where she led physician development, contracting, and sales/marketing.  Before her time at Promise, she was the Area Business Director for Kindred Healthcare responsible for 4 hospitals within the Arizona market. Jacqueline also has global pharmaceutical experience in Scientific Affairs and Business Development leadership roles including Bayer Healthcare and Astellas Pharma US.

Jacqueline holds a Master’s Degree in Business Administration from the University of Phoenix and a Bachelor of Science Degree in Biology from Murray State University.  She also holds an ASCP Medical Technology Certification from St. Mary’s Hospital, and has worked as a Medical Technologist at Vanderbilt University Medical Center at the start of her career.

NEW! ProModel’s Patient Flow Solution:

http://patientflowstudio.com/

ProModel Healthcare Solutions:

http://www.promodel.com/Industries/Healthcare

ProModel at the 2015 AUSA Global Force Symposium

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Pat Sullivan - VP Army Programs

Pat Sullivan – VP Army Programs

The 2015 AUSA Global Force Symposium in Huntsville AL proved once again to be an incredible opportunity for ProModel to learn and share.  With over 5,500 people from around the world, including key leaders from the Army, DoD and Congress, ProModel conducted office calls and provided demonstrations for senior executives from Fortune 500 companies and senior General Officer’s and Senior Executive Service members from the Department of the Army, Assistant Secretary of the Army for Acquisition, Logistics and Technology, Army Materiel Command, and Training and Doctrine Command.

The theme primary for the symposium was “Win in a Complex World.”  ProModel was on point for sharing how our tools and capabilities can assist the Army with the ominous task.  The complexity of achieving defined and desired levels of readiness at the best value served as ProModel’s mantle for discussions.

With the proven success of the Lead Materiel Integrator Decision Support Tool, that supports the BCT reorganization, the European Equipment Set establishment, and the dynamic equipping requirements in the Pacific theater; the ARFORGEN Synchronization Tool (AST) that is preparing to transition to support a new readiness model; and the Naval Synchronization Tool that assists the Navy with generating and sustaining F/A-18 readiness, ProModel already has a stronghold in the market of defense complexity.

The addition of the Logistics Readiness Center maintenance optimization capability, leaps the concept of cost wise readiness to new levels.  Attendees had an opportunity to understand how ProModel solutions can uniquely assist in solving challenges related to producing the maximum readiness at the best value.  The LRC Proof of Concept demonstrates how AMC at the enterprise levels and LRCs at the tactical level can best plan and manage capabilities, optimize resources, and maximize efficiencies within and among LRCs.

Another highlight was the demonstration of, and interest in, our COTS products like Process Simulator and Enterprise Portfolio Simulator (EPS). DOD organizations and industry are seeking ways to gain greater efficiency and to stretch their limited resources. While force structure is being reduced, missions and the need for continual modernization are not. The expectation of those funding DOD is that the military will be increasingly efficient in the execution of prescribed tasks. Therefore, an understanding of how to generate efficiency through Lean practices and events, and of how to predict equipment life-cycle costs in a very complex environment, is paramount. Additionally, leaders in DOD expressed how they must apply Lean principles to their processes, identify trade-offs, and understand the downstream impacts of change.

Process and portfolio management are significant across the government sector, and they will become even more necessary during this time of decreasing budgets. EPS and Process Simulator, coupled with ProModel’s customized solutions (AST, LMI DST, and NST), provide the foundation for rapid process improvement, budget estimation, and program management. Thanks to the exceptional hospitality of the Tennessee Valley and the great response by our AUSA hosts, ProModel continues to find new and exciting ways to assist the Army in meeting it’s motto of The Strength of the Nation.

Teaching Simulation to Graduate Students Using ProModel Products and Real-World Problems

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ProModel Guest Blogger:  Larry Fulton, Ph.D. & MSStat – Assistant Professor of Health Organization Management at Texas Tech University Rawls College of Business.  After serving 25 years in military medicine, Dr. Fulton began a second career in teaching and research.

Larry Fulton, Ph.D. & MSStat

Larry Fulton, Ph.D. & MSStat

Teaching introductory Monte Carlo, Discrete Event, and Continuous simulation to business graduate students requires at least two components beyond a good set of reference materials:   realistic or real-world problems and an excellent modeling platform allowing for relatively rapid development.  In the case discussed here, the real-world scenarios derived from interests and background of the professor and students (portfolio analysis, sustainability, and military medicine), while ProModel products addressed the platform requirements. Each of the case study  scenarios served to underscore various simulation building elements, while ProModel supported rapid  product development for a 14-week, lab-intensive course that included some  reviews of probability, statistics, queuing, and                                                    stochastic processes.

Scenario 1:  Monte Carlo Simulation (Portfolio Analysis)

Business students generally have an affinity for portfolio analysis, and I do as well. Using ProModel  features, one of the earliest student projects involves fitting univariate distributions to return rates to several funds and simulating results of investment decisions of various time horizons.  Students discuss methods that might account for covariance as well as autoregressive components in these simulations.  While developing the simulations, students also determine sample size requirements to bracket mean return on investment within a specified margin of error and confidence interval and use random numbers seeds.

Scenario 2:  Continuous Simulation using Rainwater Harvesting

Students in this course are generally from a semi-arid region (Central Texas), which has significant water shortages (so much so that desalinization is being considered.)  I rely 100% on rainwater harvesting for my home water supply, so extending this to each student’s particular home location is trivial. The “Tank Submodule” provides an easy mechanism for developing the simulations.  Students develop conceptual models of rainwater mechanism as well as flowcharts.  They gather rainfall data from the National Oceanic and Atmospheric Administration regarding rainfall and evaluate various roof sizes (capture space), demand figures based on occupants, and tank sizes. They also learn about the importance of order statistics (the distribution of the minimum in the tank) versus measures of central tendency that often dominate discussions of simulation. Finally, they incorporate tools and techniques to improve and assess V&V.

­­­Scenario 3:  Discrete Event Simulation using Military Scenarios

While serving as the Chief of Operations Research Branch for the Center for Army Medical Department Strategic Studies, I encouraged the use of MedModel for multiple DES projects.  The team built strategic models (resource constrained and unconstrained) for analyzing medical requirements for strategic operations. These same models serve as a basis for a team-based MedModel student capstone project.  The primary entity for these models was the patient with attributes of severity, injury type, and evacuation type.  The primary processes involved collection, treatment and evacuation. Resources included ground ambulances, air ambulances, medics, intensive care units, and operating rooms.   Locations were geographic locations throughout the entire of Afghanistan.  Evacuation paths were built, and treatment logic (triage, ground evacuation, air evacuation, etc.) provided the flow.

Bottom Line:  The ProModel products are outstanding for use in both teaching and industry.

 Larry Fulton Bio:

http://www.depts.ttu.edu/rawlsbusiness/people/faculty/hom/larry-fulton/

ProModel Customized Solutions: Hogistics

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There are times when the best solution is a customized solution. For those situations ProModel has a highly skilled and agile development team ready to work with you to develop the one of a kind predictive analytic solution that meets your needs.

We have created unique custom predictive analytic technology applications and training programs for the Army, Navy, and Government Agencies, as well as companies in the Aerospace & Defense Manufacturing, Pharmaceutical, Healthcare and Services Industries.

Here is just one of our latest custom solutions:

Hogistics, created in partnership with Zoetis, a global animal health company that delivers medicines and vaccines, complemented by diagnostic products and genetic tests and supported by a range of services.

Zoetis, in conjunction with ProModel, created an analytics tool to help farmers predict barn and system pig growth, mortality, and sales volume over time. This helps them achieve an optimal pound per pig as prescribed by the packing companies to which they sell.

Pork production is a highly variable process due to many factors including, genetics, environment, and disease. Other events, such as vaccine protocols, weather and individual animal care can also have an effect. Hogistics will help swine producers with the following:

  • Marketing weight and weight distribution projections weeks ahead of time
  • Data to optimize animals per sale
  • Scenario analysis capabilities to evaluate animal heath, vaccines, husbandry education
  • Pig placement, marketing and transportation schedule data
  • An inventory management tool for placement and planning of multiple pig flows

If you are interested in Hogistics view the Hogistics page on Zoetis website

Contact saleshelp@promodel.com to find out how ProModel can help your organization make better decisions – faster.

Simulation Ensures Patient Safety During Hospital Move

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Northwest Community Hospital is an acute care hospital in Arlington Heights Illinois, right outside of Chicago.  The staff at NCH had the very complex and delicate task of arranging and accomplishing the move of 150 patients over to a newly constructed facility on campus.  This is a welcome but difficult situation that many healthcare organizations find themselves in today as technology improvements and rising patient populations demand growth.

See how NCH achieved a flawless transition through predictive analytics and simulation:

Power of Predictive Analytics for Healthcare System Improvement and Patient Flow

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Hospitals are currently under intense pressure to simultaneously improve the effectiveness and efficiency of healthcare delivery in an environment where operating costs are being reduced, downsizing and consolidation is the norm, and cost for care is increasing while revenue is decreasing.  At the same time the systemic effects of peak census and varying demand on patient LOS are creating capacity issues and unacceptable patient wait times…leading to a major decline in patient satisfaction.

The amount of proposals to enhance a hospitals quality care are as numerous as the healthcare professionals dedicated to the cause.  What hospitals need however is the ability to quickly and accurately evaluate the impact of those various operational proposals and to experiment with system behavior without disrupting the actual system – and ProModel’s simulation technology is allowing them to do just that.

The predictive analytic capability of ProModel simulation will allow healthcare professionals to test assumptions and answer those patient flow “what if” questions in a matter of minutes and days, not weeks and months.  Simply put, it’s providing a decision support system to assist healthcare leaders in making critical decisions quickly with a higher degree of accuracy and confidence.

Simulation will also help healthcare staff quickly identify room availability and recognize high risk patient flow bottlenecks before extreme problems occur.  This invaluable knowledge will then lead to reductions in patient wait times and LOS, avoid unnecessary re-admissions and costly expansions, and most importantly – increase the overall quality of service and patient satisfaction.

Teaching Process Management Using ProModel

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ProModel Guest Blogger:  Scott Metlen, Ph.D. – Business Department Head and Associate Professor at University of Idaho

Scott Metlen, Ph.D.

Scott Metlen, Ph.D.

Understanding process management, the design, implementation, management and control, and continuous improvement of the enterprise wide set of an organizations processes is the key to well deployed strategies. It was not until Tim Cook made Apple’s total set of processes world class including all supply chain linked processes (Brownlee, 2012) that Apple hit its amazing climb to become the world’s highest valued company; even though the company had cutting edge products before his arrival. Gaining effective understanding of process management is not easy due to the strategic variability inherent in the portfolio of products that companies sell, and in markets they service. This strategic variability (Rajan, 2011) in turn drives variability in many processes that an organization uses to operate. For instance, different markets require different marketing plans supported by different processes.  Order processes often vary by product and target market. Employee skill sets differ by product requiring different hiring and training processes. Different products, whether it be services or goods that have a slight variation require, at the very least, an adjustment to the production process. Adding to, and often caused by the variability just mentioned, are multiple process steps, each with different duration times and human resource skills.  Depending on what product is currently being produced, process steps, process step order and duration time, interdependency between the process steps, and business rules all vary. Where a product is in its life cycle will drive the experience curve, again creating variation across products. In addition, the numerous interfaces with other processes all vary depending on the product being produced. All of these sources of variability can make process management hard to do, teach, and learn. One tool that helps with process management in the face of variance is discrete event simulation and one of the best software suites to use is ProModel. ProModel is a flexible program with excellent product support from the company.

Effective process management is a multi-step process. The first step of process management is to determine the process flow while at the same time determining the value and non-value added process steps. Included in the process flow diagram for each step are the duration times by product and resources needed at each step, and product routes. Also needed at this time are business rules governing the process such as working hours, safety envelopes, quality control, queueing rules, and many others. Capturing this complex interrelated system begins by visiting the process and talking with the process owner and operators. Drawing the diagram and listing other information is a good second step, but actually building and operating the process is when a person truly understands the process and its complexities.  Of course many of the processes we want to improve are already built and are in use. In most cases, students will not be able to do either of these. However, building a verified and validated simulation model is a good proxy for doing the real thing, as the model will never validate against the actual process output unless all of the complexity is included or represented in the model. In the ‘Systems and Simulation’ course at the University of Idaho students first learn fundamentals of process management including lean terms and tools. Then they are given the opportunity to visit a company in the third week of class as a member of a team to conduct a process improvement project. In this visit students meet the process owner and operators. If the process is a production process, they walk the floor and discuss the process and the delta between expected and actual output. If the process is an information flow process, such as much of an order process, the students discuss the process and, again, the delta between expected and realized output. Over the next six weeks students take the preliminary data and begin to build a simulation model of the current state of the process. During this time period students discover that they do not have all the data and information they need to replicate the actual process. In many cases they do not have the data and/or information because the company does not have that information or how the model is operated is not the same as designed. Students then have to contact the process owner and operators throughout the six weeks to determine the actual business rules used and/or make informed assumptions to complete their model.

Once the model has been validated and the students have a deep understanding of the process, students start modeling process changes that will eliminate waste in the system, increase output, and decrease cost. Examples of methods used to improve the process include changing business rules, adding strategically placed buffers and resources, and reallocating resources. To determine the most effective way to improve the process, a cost benefit analysis in the form of an NPV analysis is completed. The students use the distribution of outputs from the original model to generate appropriate output and then compare that output to output pulled from the distributions of each improvement scenario. This comparison is then used to determine a 95% confidence interval for the NPV and the probability of the NPV being zero or less. Finally, several weeks before the semester is finished, students travel to the company to present their findings and recommendations.

Student learning on these projects is multifaceted. Learning how to use ProModel is the level that the students are most aware of during the semester, as it takes much of their time. However, by the end of the semester they talk about improving their ability to manage processes, work in teams, deal with ambiguity, manage multiple projects, present to high level managers, and maintain steady communication with project owners.

Utilizing external projects and discrete event simulation to teach process management has been used in the College of Business and Economics at the University of Idaho for the past six years. As a result, the Production and Operation area has grown from 40 to 150 students and from five to 20 projects per semester. More importantly, students who complete this course are being sought out and hired by firms based on the transformational learning and skill sets students acquired through the program.

References:

Rajan Suri. Beyond Lean: It’s About Time. 2011 Technical Report, Center for Quick Response Manufacturing, University of Wisconsin-Madison.

Brownlee, John. Apples’s Secret Weapon 06/13/2012. http://www.cnn.com/2012/06/12/opinion/brownlee-apple-secret/index.html?hpt=hp_t2. 12/301/2014.

Scott Metlen Bio:

http://www.uidaho.edu/cbe/business/scottmetlen