Power of Predictive Analytics for Healthcare System Improvement and Patient Flow

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

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

 

ProModel and MedModel 2014

Kevin Field

Kevin Field – Sr. Product Manager

In regards to this release, I would like to start out by saying, in the words of Nacho Libre, “It’s pretty dang exciting, huh?

With ProModel and MedModel 2014 we’ve tried to keep our current customers in mind as well as new customers. For current customers, the new logic windows with Intellisense and Syntax Guide should help you build models faster and easier. And being able to import graphics from third party graphic programs like Photoshop, Gimp, Paint.Net, etc. should even be more useful now that you can rotate all graphic types in the application. The improvements to the Debug window are a direct result of our work on the new logic windows.

For our new customers, the redesigned Getting Started panel (formerly known as the Control Panel) brings a lot of model building resources to the forefront. We have added new demo models and refreshed several of our previous ones. Did anyone even know we had a Quickstart video, showing you how to build a simple model and analyze results in 10-15 minutes? The most exciting part might be the How To videos our Support team has been producing for several months now. All of our customers will find these extremely helpful.

In this blog I am going to casually comment on some of the new features with the assumption that you have already reviewed What’s New in 2014 and perhaps even viewed the webinar I gave on this release. If not, you might want to consider doing so, otherwise…you can blissfully continue on with me…

New Logic Windows

It’s amazing what a few simple colors can do to help your logic be more readable. As we were developing version 9.1, I found it more and more difficult to go back to 8.6 and “drag” myself through the dreary old plain black text 🙂 It’s funny how refreshing it was to get back to 9.1! Not only the color but also line numbers really make it easy to quickly get around in the logic.

1

 

 

 

 

 

 

 

And if you don’t like our default color scheme or want to have something a little easier on the eyes, simply customize the colors in the Logic Color Selection dialog.

2

 

 

 

 

 

 

We also want to encourage good formatting in the new Logic windows by utilizing white space (spaces, line breaks, etc.) and indentation. Don’t be afraid of it! By automatically indenting and out-denting after begin and end brackets, we hope to make co-workers everywhere more willing to leap in and review your logic with you! Auto-formatting is something we are looking to improve moving forward.

Another thing we have made steps to do is deprecate certain logic elements. Begin, End, and the # comment are the main ones. Don’t worry though, they are not completely gone! They won’t show up in the Intellisense list but they will still compile if used in logic. Begin and End are easier to read and enter in logic if you use the “squiggly” brackets { and } instead. And we want to use the # character for other things like the new #region statement.

In fact, #region is one of my favorite new additions to 2014. I love the ability it gives you to section your logic and collapse it with a label describing what’s inside that hidden portion of your logic. I hope you’ll find it quite useful.

Intellisense and Syntax Guide

These new features are probably the heroes of this release. Intellisense brings every statement, function, location, entity, variable, subroutine (I’m saying every model element!) right to your fingertips. You should almost never have to remember your element names or copy them from one place in logic to another, or even leave a module to go look it up. Besides that, the days of completely typing any logic or element name are gone. This should increase your productivity by at least 10-15% 🙂 Are you with me on this?!

3

Intellisense coupled with the Syntax Guide should nearly make the Logic Builder obsolete. There may be a few things we need to add in order to make that happen. Please feel free to share any suggestions you may have. We tried to make both unobtrusive to your logic creation and editing. Because of this, we didn’t add an option to hide Intellisense or the Syntax Guide.

4

 

 

 

Debug Window

MORE THAN 3 LINES!! I think that’s all I need to say on that.

Ok, I’ll also say that debugging should almost be a joyous endeavor as you are now able to anticipate what logic may get executed next and better understand where you came from.

Routing Probability

I’m going to refer you to the webinar I gave on this new feature. In it I give a great example (if I do say so myself) of how simple it is to set up a routing probability for scenario analysis. One thing to remember, in order to use an array in the routing Probability field, the array must be initialized through an import.

Getting Started Panel

The new panel that appears when you start the program may primarily be geared toward new users, however current customers may find it just as useful. Access to the How To videos, online Help, and additional training resources (like dates of future ProModel training classes and a link to ProModel University, our online self-paced training).

5

If you haven’t taken advantage of your M&S contract and utilized our Technical Support team then perhaps the Getting Started panel will help facilitate this. They are a tremendous resource to assist you in understanding different techniques for modeling aspects of your systems, troubleshooting your models and helping you get out of the paper bag you may have coded yourself into, or just a friendly person to talk to 🙂 We like to call them your “ProModel Friend”.

Speaking of the Support team, they have done a tremendous job of generating a lot of How To and Solution videos for quite some time now. The short videos range from 2-5 minutes and offer useful insight into modeling techniques and other useful software tips. Let us know if you have any suggestions for more videos!

New Graphic Libraries

A final word about our new graphic libraries. In order to create new libraries containing EMF (vector-based) files, which scale nicely when zoomed, we had to support the rotation, flipping, and sizing of these image types within ProModel. This makes it so you don’t have to generate an image for every possible rotation or flip you need to have for your animation. This reduces the size of the graphic library and thus your model footprint as well. So with this new capability, you should be using a third party graphics program like Photoshop or Gimp (which is free) to create your graphics. (Or perhaps get your coworker to do it, just don’t tell them that I suggested it.)

I can’t talk about the new graphic libraries without mentioning Laif Harwood, a member of our Support team. Laif gets credit for creating all the new graphics in the libraries. And a fine job he did! So if you want any tips on how to do it for yourself, give our Support team a call!

Well, that’s all I have steam for yammering about today. Remember…you have a ProModel Friend that’s just an email (support@promodel.com) or phone call away (888-PROMODEL).

 

Mitigating the Hawthorne Effect with Bruce Gladwin

Bruce Gladwin, PMP - Vice President, Consulting Services

Bruce Gladwin, PMP – Vice President, Consulting Services

With over 25 years of experience in the simulation field, Bruce has worked with major corporations worldwide developing hundreds of models across a wide range of industries. In his 19-year tenure with ProModel, he has served as a Product Manager, Senior Consultant, and Simulation Trainer. Bruce was named VP of Consulting Services in 2005 and has oversight responsibility for ProModel’s Consulting and Customer Service Operations.

Bruce received a BS in Systems Engineering from the University of Arizona and an MBA from Brigham Young University. He is a certified expert in Lean production principles and received his Six Sigma Black Belt certification while employed at General Electric’s Power Systems division.

Key projects include:

  • Capacity analysis for GE Energy Products Europe – determined the maximum production capacity for gas turbine components at GE’s European manufacturing facility resulting in a savings of $9.6M  in capital avoidance.
  • Design of a green-field manufacturing site for production of GE industrial generators – resulted in a savings of $1.2M in capital avoidance and identified the need for an accelerated operator training program.
  • Design and analysis of a disassembly process for the Russian-built SS25 Intercontinental Ballistic Missile (ICBM) in support of the 1991-92 START treaties between the US and the Soviet Union

Check out Bruce’s presentation on the Hawthorne Effect from the 2013 Winter Simulation Conference and his work with a major home improvement retailer…

ProModel on The Lean Nation

ProModel’s Bruce Gladwin (V.P., Consulting) and Dave Tucker (Director, LSS Initiatives) join web and radio host Karl Wadensten on “The Lean Nation” to discuss the benefits of ProModel Simulation in lean initiatives.  Enjoy!

Probing LEAN Space with Dave Tucker

Dave Tucker

Dave Tucker – Director, LSS Initiatives
Lean Six Sigma Master Black Belt

Most companies have the same basic question they are trying to answer from a model project.  How can I make more stuff quicker?  Whether it is manufacturing, government, healthcare, or most any other industry, they all want to get more items through their processes faster and often they want to do it with fewer resources.  That’s the climate we are in now.  Everyone has to do more with less.

I have observed that many problems in Manufacturing can be directly attributed to having too much WIP.  Excess WIP inventory ties up money, creates the need for storage, increases cycle time, reduces throughput, and wastes Resources time.  But Managers want to keep everyone busy so they allow more work to be introduced into their systems instead of looking for Lean ways to better manage the “pull” of work.  Companies that learn to control the amount of WIP to meet their orders always do better financially then other companies that continually flood the workplace with inventory.

So I get excited when a model shows some new information that a company has never seen or understood before.  When they can see the process waste, understand how to remove it and implement the plan – that’s a great thing.

Check out Dave’s work on the Space Shuttle Program with United Space Alliance and NASA…. 

ABOUT DAVE

Dave Tucker is ProModel’s Director of Lean Six Sigma (LSS) Initiatives and also serves as a Senior Management Consultant and Project Manager.  He assists our clients primarily by providing simulation training, model consulting services, and LSS implementation advice.  Prior to joining ProModel, Dave was the Lead Lean Six Sigma (L6S) Master Black Belt at United Space Alliance (USA), located at the Kennedy Space Center in Florida.  USA is the prime contractor to NASA responsible for the Space Shuttle Program.

Dave has over 25 years’ experience leading teams, mentoring employees, solving problems, conducting training, and improving operations. He has led more than forty Kaizen Events, completed dozens of process simulation modeling projects, conducted hundreds of training sessions, facilitated over two hundred Belts & Team Leaders, and assisted with the implementation of numerous process improvements saving millions of dollars.

Dave has an extensive background in numerous process improvement tools utilized in Lean Six Sigma DMAIC & DMEDI approaches, as well as Kaizen team methods and process simulation modeling.  He has about 14 years’ experience using ProModel process simulation modeling tools for process improvement.  In addition, he is a sought after speaker and has made many well-received presentations at Process Improvement, Simulation, Industrial Engineering, and Aerospace Conferences.  He has a BSBA in Management from the University of Central Florida.  Dave is a Certified Lean Six Sigma Black Belt and a Certified Master Black Belt.

Ready to Turn Pro?

Get ready for quicker, easier model building with PCS Pro – a brand new level of Process Simulator combining its original ease of use with an enhanced feature set enabling faster model building, more complex processes and improved model maintainability.

Contact your ProModel Rep at 888.900.3090 or email us at pcspro@promodel.com for more information.