Simulation Explained, Simulation in Healthcare

Four benefits of using simulation for quality improvement in EDs

Discrete event simulation software is a very powerful tool for healthcare decision making. By using simulation software like SIMUL8, hospitals are able to test ideas and assumptions for emergency department (ED) quality improvement projects.

EDs are challenged with efficiently managing patient flow/throughput, delays or waiting times, capacity and resource utilization against daily varying demand for their services. However, balancing shorter waiting times with potentially excessive resourcing (which also creates higher ED costs) can be hard to get right. It can also be difficult to know how changes to operational processes could ultimately positively or negatively impact ED patient flow and outputs.

This is why providers like Johns Hopkins Health System rely on healthcare simulation software like SIMUL8, to examine and test flow systems in EDs and improve their operational efficiency in a low-risk environment.

Johns Hopkins’ Senior Project Administrator, Eric Hamrock, outlines four of the fundamental benefits of using simulation for quality improvement projects in an ED environment:

Eric Hamrock

1. Simulation is powerful

The first thing I think when we think about discrete event simulation is that it is a very powerful predictive analytics tool.

We often have gut feelings about things we want to change, but simulation allows us to look into the future and to say, ‘Well, if we did this and made these assumptions, what would the outcomes of that be?’

This is very effective in settings such as the emergency department where there is a lot more variation and unpredictability, particularly in how patients arrive.

2. Simulation is visual

Discrete event simulation software is a highly visual tool, allowing people to see complex systems in a very easy to understand way. This is especially valuable as we often have different stakeholders involved that we need to get excited about a project.

The people that I would work with would be physicians, nurses, or other front line staff from ancillary departments, and then administrators, finance individuals, and sometimes even patients are involved in the process.

We want these different stakeholders to come in, give them the same sheet of music, see where we can agree, and then start to talk about what scenarios are possible for improving emergency department processes.

3. Simulation is flexible

Discrete event simulation is an extremely flexible tool; we can provide many different inputs and see how those affect each other across very complex systems.

Along similar lines of getting everyone on the same page, simulation allows us to have an environment of objectivity. I was previously an administrator of nursing homes, and in my experience many of the decisions I would make were purely based on what I was hearing from my staff.

There were times where people would say, ‘Well, we think this is what it is and this is what we should do.’ It is really valuable to now have a tool that we can use to say, ‘Well, this is what the data says that it is doing.’

4. Simulation offers risk-free insight and answers

Some of the questions that we can ask in the ED: What if we add capacity? We add space or staff? We receive more or fewer patients? Reduce boarding time? Adopt a new model of care (fast track, short stay, etc.)? Reconfigure or add additional care areas?

Many times people say, ‘If I just add more space or if I just add more staff, we could do this.’ Many times they are correct, but simulation gives us some hard evidence to be able to do that.

What find simulation allows us to test in a setting that is less risky. If we were to add staff and say, ‘Let’s try to add another nurse to this shift,’ that costs money. This can also cause changes to staff performance, and if you are always changing these things, it is much easier to see the knock-on effects in a risk-free setting using simulation.

Find out more about how Eric and Johns Hopkins are using simulation in the full Emergency Department Throughput: Using DES as an effective tool for decision making webinar recording.

Learn more about using SIMUL8 for healthcare process improvement

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