Tag Archives: Healthcare Architects

Architectural Firm Compares PACU Designs with Ease Using MedModel

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A post-anesthesia care unit, PACU, is a vital area within every hospital where patients can recover  from general anesthesia, regional anesthesia, or local anesthesia.

ProModel built a PACU model for an architectural firm to illustrate the difference between two design options.  This was accomplished by placing both designs in one model and having patients follow the exact same patient pattern as they enter the PACUs simultaneously.

The left or A side of the model is a Single Room design and the right or B side is an Open Bay design.  There are the same number of conceptual uses of PACU I beds in each design.  The A side has 27 dual designated pre-op and PACU II rooms.  The B side has 30 rooms, but designates specific rooms for pre-op and specific rooms for PACU II.  Macros were used extensively during the model build to enable rapid changes to the interactions of the patients within the designs.  Real arrival patterns from the hospital were used and entered using an arrival spreadsheet.

PACUComparison

The simulation revealed that the A side showed significant time savings.  Were the ORs to be kept open the same length of time, more patients could be seen on the A side.  The A side also reduced the time spent waiting, after initial arrival for a pre-op bed.  For example, the average wait for pre-op bed on the A side was 3.9 minutes.  On the B side this average was 52.8 minutes.  That’s a pretty significant difference!

These and many other solution videos are available on our YouTube Channel.

If you would like more information about ProModel solutions contact us.

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.

Designing Better Care For Your OR

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JCowden Profile Pic

Jennifer Cowden – Sr. Consultant

Earlier this year, my family and I took a vacation to a certain kid-friendly theme park.  As we wandered from ride to ride, we couldn’t help but note that, even at the peak times on the more popular rides, you rarely saw crowds standing outside waiting. The long lines were all contained within a succession of fairly climate-controlled rooms that obviously took some thought to plan. This particular company is big into predictive analytics, so I would hazard to say that they didn’t just guess at the maximum size of the line at peak time; they are probably not going to go live with a new attraction or other big change unless they simulate it first.  An interesting dynamic that we observed was that when a wait time for an attraction was lowered on their new mobile app, we could literally see the “flash mob” of patrons converge on that ride, causing the line to go from a 10-minute wait to a 30-minute wait in the blink of an eye.  I turned to my husband, who is also an engineer and a geek, and said “I wondered if their model predicted that.”

Theme parks obviously need to be concerned about a positive overall  visitor experience; after all, they are always competing for discretionary funds with other sources of entertainment.  Now, more and more hospitals are developing that same mindset: being cognizant of the overall patient experience to the point of modeling new spaces before they go live.  How many OR rooms should they outfit for opening day, and how many can wait?  How can they make the best use of the spare rooms?    Is there enough space in the corridors that the patients won’t feel too crowded?  Is there enough space in the waiting areas for the families of the outpatients?  How many staff members do they need for each department to minimize patient wait time?  Are there any unforeseen bottlenecks due to sudden dynamic shifts?  These are just a few of the questions that simulation can answer.

Check out Jennifer’s Ambulatory Care/OR Suite Model:

About Jennifer

Before joining ProModel in 2013, Jennifer spent 15 years in the automation industry working for a custom turnkey integrator. As an Applications Engineer she built simulation models (primarily using ProModel) to demonstrate throughput capacity of proposed equipment solutions for a variety of customers. Jennifer’s experience covers a wide range of industrial solutions – from power-and-free conveyor systems to overhead gantries and robotic storage and retrieval systems. She has also created applications in the pharmaceutical, medical device, automotive, and consumer appliance industries.

Jennifer has a BS in Mechanical Engineering and a Master of Science in Mechanical Engineering from the Georgia Institute of Technology.

Busy Season at ProModel

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Keith Vadas

Keith Vadas – ProModel President & CEO

I am pleased to report ProModel’s second quarter was very positive.  Like many businesses in the US we find ourselves on a serious upswing this Summer of 2014.  Our consultants are working on several projects in a variety of industries, including ship building, power management, retail, manufacturing, food processing, and government contracting.  In all of these projects our experienced team of consultants is working to improve efficiency, save money, and make better decisions for their clients.

ProModel’s DOD projects continue to thrive.  It is hard to believe it has been eight years since we started working with FORSCOM (US Army Forces Command)   on AST (ARFORGEN SYNCHRONIZATION TOOL).  LMI-DST (Lead Materiel Integrator – Decision Support Tool) with the LOGSA Team (US Army Logistics Support Activity) is also going strong.  Our agile team of software developers keeps improving the development process within ProModel and it shows. Just recently the NST Airframe Inventory Management Module was Granted Full Accreditation by the Commander, Naval Air Systems Command.

The time is also ripe for opportunities in Healthcare.  Our patient flow optimization capabilities are perfect for helping hospitals and outpatient clinics improve efficiencies.  Now that the Affordable Care Act has been around for a couple of years, its impact is being felt by healthcare organizations around the country.  The expanded insured-base, and the need for improved processes and different care models is making it absolutely necessary to consider the value of modeling and simulation.  ProModel continues to work with several facilities including Presbyterian Homes and Services, and Array Architects who enhance the flow in Healthcare Facilities design by using MedModel simulation in their design processes.

To better support our base of existing customers, we just released ProModel/MedModel 2014 in July and PCS Pro 2014 at the end of Q1.  EPS 2014 (Enterprise Portfolio Simulator) was released in Q2  and includes a new easy to use, web-based rapid scenario planning tool – Portfolio Scheduler.  You can check this tool out online at – http://portfoliostud.io/#.

There continue to be lots of exciting things happening at ProModel.  We have an outstanding team of consultants and software developers-designers just looking for an opportunity to PARTNER with you to help you meet the next business challenge, or solve the next unexpected problem.

ProModel and MedModel 2014

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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.

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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.

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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?!

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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.

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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).

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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).

 

Staffing Simulation Model Helps Transitional Care Nursing Home

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In the May 2014 Edition of IE Magazine (Institute of Industrial Engineers) ProModel client Gavin L. Collins features his groundbreaking simulation work in the Elder Care field using MedModel software to improve staffing and overall care at Boutwells Landing Care Center, a transitional care unit which is part of Presbyterian Homes and Services Continuing Care Campus in Minnesota. In the case study Collins details his work in building an effective model, how ProModel helps you visualize the system you’re working with, and how the proper solution becomes a model for future efficiencies. The Healthcare industry is just starting to realize the importance and value that predictive analytics and simulation holds for both patient care and the industry as a whole, and unfortunately the Elder Care field has even less experience utilizing this innovative solution technology.  Both Mr. Collins and ProModel sincerely feel that simulation can improve the care that we offer our elders when they need it most.

Read the full IE article here:

Simulated Staffing by Gavin L. Collins

Copyright 2014 by the Institute of Industrial Engineers

Gavin Collins has done special projects for Presbyterian Homes & Services, served as an assistant professor at the University of Minnesota, and worked as a resident assistant, trained medication aide, engineer and administrator at Crestview Lutheran Home.  He earned his bachelor’s degree in accounting and finance and his doctoral degree in economics from the University of Iowa.

Enhancing Flow in Healthcare Design with Simulation

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Guest Blog Post - Written by Noah M. Tolson - AIA, LEED AP BD+C, Lean Green Belt -Principal and Practice Area Leader, Planning

Guest Blog Post by Noah M. Tolson – Array Architects Principal and Practice Area Leader, Planning – AIA, LEED AP BD+C, Lean Green Belt

Discrete Event Simulation (DES), which has been utilized across industries for several decades, provides a virtual environment to track and visualize patients, equipment and providers as they move through the steps of care. It is an important tool in supporting Lean Design in the healthcare environment.

In order to achieve the desired physical environment, healthcare architects rely on a vast amount of data – and the tools for harnessing that data are becoming more advanced. Just as BIM (Building Information Modeling) optimizes early decision-making in the design phase, so to can Discrete Event Simulation (DES) influence the design of workflow and patient flow prior to construction.

At Array, we have found that this virtual environment gives us the ability to test a multitude of ‘what if’ scenarios with our clients to understand the impact that different layouts have on workflow, patient flow and resource utilization. The result is an increased confidence that the design will support current needs, as well as provide insight on incorporating flexibility into the design to accommodate the inevitable changes that will come in the future.

There are three key advantages DES provides over other methods of analysis:

 

1)      Real life variability can be applied to critical key measurements such as:  patient demand, times to complete key tasks, wait times for key resources or simply waiting for care, etc.

 

2)      Naturally occurring constraints exist when the demand for services/resources exceeds capacity. DES models allow constraints to be included by identifying the interdependencies between resources available and resources required.

 

3)      DES models simulate the passing of time (into the future) and record key metrics such as wait times, processing times, resource utilization and equipment utilization as they relate to varying patient demand and varying patient acuity. This helps with the daunting task of attempting to predict when the care is to be provided and by whom.

 

Utilizing Lean Design, architectural teams appropriately spend time observing and recording work flow and patient flow to document and understand the current state. Accurately predicting the future state work flow and patient flow has always been difficult to project and arrive at consensus because workflow analysis has traditionally been based on averages. While averages are a good place to start, they don’t tell the entire story. This is where DES, due to the advantages described above, is highly valuable. Using a DES tool like ProModel’s MedModel, Process Simulator or Patient Flow Simulator to model the various hospital processes in the new structure, we can provide much more insight into the effectiveness of potential designs. DES helps evaluate the workflow, resources and patient demand more realistically and simultaneously which allows healthcare decision-makers to be more confident in the design solutions.

Case Study

MedModel was recently used to help one healthcare organization evaluate a newly constructed 220,000 SF outpatient facility. The facility was intended to centralize the services of affiliated specialty practices and education & research centers. This five-floor clinic would allow 65 providers from 13 different practices throughout a specific region to converge in one patient-friendly location. Quality and service was expected to increase greatly by having referring physicians in one collaborative environment. Spreadsheet models were initially used to study the consolidation and facility design project, but provided only static information that relied heavily on the use of averages. This made it hard to accurately study the many complex processes that occur continuously in an outpatient setting. With the limited data available, physicians and administration had difficulty reaching consensus on space requirements and efficient room utilization. At issue, could the newly consolidated practices operate comfortably on the first and third floors, or did they need additional space? A MedModel solution proposed first and third floor designs of the clinic in order to analyze capacity and resources against the current data on patient flow from all the converging practices. The simulation examined the individual practices over a five day period (Monday through Friday) during regular business hours. The measuring criteria consisted of the following:

Exam room utilization

Physician and staff utilization

Number of patients in check-in

Time spent in check-in queue

Patient activity times

Number of patients in imaging queue

After multiple scenarios were run, the output data confirmed there would be sufficient room for the consolidation of practices on the first and third floors. In fact, the analysis showed that on certain days of the week there were not enough providers to fill the capacity on those two floors.

This is one example that illustrated the advantages of DES. Array and ProModel have used similar methods to more accurately project operational outcomes and compare design solutions.

To Expand or Not to Expand? Medical Clinic Simulation with Jennifer Cowden

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JCowden Profile Pic

Jennifer Cowden – Sr. Consultant

Less is More

I once worked with a programmer whose motto was “Pay me by the line of code,” and, not surprisingly, his code was often lengthy, inefficient, and hard to follow.  I’ve always preferred the opposite approach;  it is an interesting challenge to try to get the same functionality into as few lines of code (or alternately, as few process records) as possible.  Also, employing reusable blocks of code cuts down on the opportunities for mistakes and overall debugging time.   When I was an applications engineer at an automation company, I often had to get assembly lines modeled in a very short turn around.

Luckily, ProModel’s macro and subroutine modules made implementing reusable code very simple.  For the medical clinic model demonstrated in this post, we took flexibility a step further by using the “ALL” option in the process edit table.  Even though this model was built to simulate eleven different clinic layouts individually, and contains over 500 patient locations, this model contains a total of only seven process records.  Adding new clinic layouts now takes a fraction of the time and can be done with minimal code adjustments.  If you have a repetitive process, or one that needs to be flexible to add workstations quickly, this methodology could save you modeling time as well.

Check out Jennifer’s work on the Medical Clinic simulation model:

 

About Jennifer

Before joining ProModel in 2013, Jennifer spent 15 years in the automation industry working for a custom turnkey integrator. As an Applications Engineer she built simulation models (primarily using ProModel) to demonstrate throughput capacity of proposed equipment solutions for a variety of customers. Jennifer’s experience covers a wide range of industrial solutions – from power-and-free conveyor systems to overhead gantries and robotic storage and retrieval systems. She has also created applications in the pharmaceutical, medical device, automotive, and consumer appliance industries.

Jennifer has a BS in Mechanical Engineering and a Master of Science in Mechanical Engineering from the Georgia Institute of Technology.

Healthcare Guest Blog from Array Architects

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Co-Authors:

Florangela Papa, LEED AP – Project Architect and Planner, Array Architects

Ryan Keszczyk – Intern Architect, Array Architects

Array Logo Lockup-Inline_CMYK-01We are Healthcare Architects.  When designing for the healthcare industry, we must respond to the increasing complexity of demands and restrictions based on spacing limitations, budgets, and resources.  As our healthcare clients adapt to their changing needs and experience a shift in operations and process, we needed to find a way to use real-time information and data to generate both tangible and quantifiable statistics that could be used to steer design.  These criteria led us to search for new tools that would allow us to analyze this data in a way that could improve our design process.  Simulation modeling is a tool that has drastically impacted the design process, increasing the value, flexibility, and quality of our designs while staying within the confines and restrictions of each individual project.  The once static historical data on spreadsheets and charts can now be analyzed in a visually dynamic way.  Using this technology we are able to visually see system bottlenecks and flawed areas of the process that have the most potential to improve the design, all in a virtual environment, before the project is too far along in the design process.  With simulation we can:

-Analyze existing conditions and identify areas within the project scope that need development and offer the most value and improvement to the facility.

-Create project specific analyses and solutions that become the guiding force of a design, rather than using standard baseline benchmarks.

-Identify and analyze system flows and processes that can be improved with the introduction of lean design practices.

-Quickly test different scenarios which give the client the ability to weigh the outcomes and make an informed and confident decision.

Simulation modeling is used in early stages of design to influence programmatic developments.  For example, using simulation modeling we are able to specifically calculate the number of patient rooms a department may need to minimize wait time and further improve quality of care.  Through the modeling process we are able to ensure that the critical elements are precise, not just for a typical day, but have the ability to perform in  “worst case scenario” circumstances.   With the broad scope of a project determined, modeling can be used at a focused scale to evaluate the inter-dependencies of individual elements within the system and influence the design accordingly (i.e. patient room flow, nurse station flow, etc.)

Simulation Modeling is often considered both an art and a science.  Models can be developed to produce extremely rigorous and complex systems, but also need to strike the right balance of simplicity and usefulness.  As architects we needed a simple tool that could give us the benefits of simulation, without requiring too extensive of a statistics and engineering expertise – this isn’t our strength, nor is it how we are compensated.  After evaluating different software, Array selected ProModel’s Process Simulator because:

– It has a user-friendly interface with visually dynamic graphics.

– ProModel offers effective training and tutorials backed by great technical support

– There is a variety of graphics (graphs, charts, histograms, time plots) that are easily customizable to meet the needs of the project through the output viewer.

– The software has the ability to create simple or complex models, which allows the flexibility to model for a variety of project types.  We are able manage many projects on our own, but can also team with ProModel’s experts as we tackle more complex problems.