Simulating Orthopedic Activity in the
Physiotherapy Department of an
Irish Hospital
2nd International Conference on Computers and Management
CAMAN 2012
Wuhan, China
9-11 March 2012
Malcolm Brady1, Vikas Kumar2, Arijit Bhattacharya3
Management & Information Systems
Dublin City University Business School
Dublin, Republic of Ireland
1malcolm.brady@dcu.ie; 2vikas.kumar@dcu.ie; 3arijit.bhattacharya@dcu.ie
Jun Dai5
School of Information Management
Wuhan University
Wuhan city, Hubei province, China
daijun@whu.e
5The
4The
V.N.S.A. Kumar4
Department of Industrial Engineering and Management
Indian Institute of Technology, Kharagpur, India
saianjani.iitkgpian@yahoo.comdu.cn
The Hospital
• Large acute general hospital
• Located in Dublin suburbs
• Serves community of 290,000 people, many
elderly
• Over 800 beds
• Over 3000 staff
• 143,000 outpatient visits
• 45,000 emergency visits
• Large physiotherapy department
Multi-step research approach
Interview key
people
Simulate the
event
Examine
documentation
Map the
event
Observe the
event
Taxonomy of simulation approaches
Simulation
modelling
Discrete event
simulation
Systems
dynamics
Monte Carlo
simulation
Agent based
simulation
Discrete event simulation in
healthcare: literature
DES in Healthcare
Patient Bed sizing Resource Economic Communication Scheduling Patients' Healthcare
attendance supply chain
utilisation factors
flow
among
and
[24]
behaviour
[23]
[8, 18, 20, planning [11, 12, 19, [13, 14, stakeholders
[22]
20]
[17]
21]
15, 16, 20]
[9, 10]
High level process map of
physiotherapy department activity
Referral
Cancellation
Discharge
Appointment
Triage
No show
Treatment
Detailed map of
physiotherapy
treatment process
Start
Verify referral /
appointment
No
New patient?
Yes
Record patient
details
Fracture?
Database
Yes
Immediate
appointment
No
Referral card
in triage box
Triage box
Treat patient
Yes
Return
appointment
Further
treatment?
No
Discharge
patient
End
End
End
Simulation model (Simul8)
Conclusion
• Simply mapping out the process clarified the
situation for the various actors
• Several small but significant improvements
followed
• Simulation allowed a new scenario to be
tested at relatively low cost and with no
disruption to activity