SimLean Educate Interlude 1

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SimLean EducateInterlude 1 Level the Load

• Using an example of a generalised simulation of a
  theatre process

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The generalised Day Case theatre process
Run the model
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2 batch
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Patient flow 2 Batch
Day 1
Day 2
Day 4
Day 5
Day 3
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Patient profiles 2 Batch
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Patient queueing times 2 Batch
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Level the Load?

• Lets look at spreading arrivals across 6 batches
• Sounds scary?
• How about a small change
• Patients arriving at 800, 830, 900
• Patients arriving at 1300, 1330 and 1400

Run the model
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6 batch
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Impact on Patient flow
2 Batch

• The number of patients on the premises is never
  more than 17 (compared to 24 under 2 Batch)
• Fewer morning patients remain in the system at
  1pm (less stress on staff and patient)
• Little effect on departure pattern as same
  amount of work to be done

6 Batch
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Comparison of Patient profiles
6 Batch
2 Batch
Improved patient value
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Queue for Reception
Averages
Improved patient value
2 Batch 14 mins
6 Batch 4 mins
2 Batch and 6 Batch 13.3 booking in
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Queue for Prepare and Hold
2 Batch 6 batch 42 other 48 38
blocked 32 20 work 20
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Queue for Discharge Process
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Patient flow through Theatre and Recovery
2 Batch 6 batch 35 other 37 5
blocked 3 60 work 60
2 Batch 6 batch 68 other 71 17
blocked 14 15 work 15
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Summary

• We have made a slight change toward spreading
  patient arrivals and levelling the load. This
  small change has been shown to
• Reduce patient queuing times
• Reduce the number of patients on the premises
• Is the principle of levelling the load
  something you could use?
• Do you think this small change goes far enough?

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Interlude insight

• If you always do what you always did-you'll
  always get what you always got

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THE SLIDES THAT FOLLOW ARE FOR FURTHER INSIGHT
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Patient flow (numbers)2 Batch 6 Batch
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Does 6 Batch cause later finish times?
2 Batch - Time View
Day 1
Day 2
Theatre finish time on Day 2
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Does 6 Batch cause later finish times?
2 Batch - Time View
6 Batch - Time View
? Theatre Finish Times ?
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