Simul8 provides a clear guide to deployment of resources

The covid pandemic has had a knock-on effect on all aspects of the NHS, with every department seeing an increase in waiting list times. The government has recognized the impact that the pandemic has had on the health service and has published plans to reduce waiting lists.

In these circumstances, health trusts are looking for innovative ways to optimize the efficiencies of their departments, to deal with the backlog, and to maintain quality services being offered to patients.

Working out logistics in hospitals can be immensely challenging. All sorts of issues could complicate the process: patients could miss appointments, staff could be called to assist in other departments under pressure, doctors could be tied up in medical emergencies, treatments could take longer than expected, there could be a major incident within a city – there are so many reasons why it’s difficult to plan. Consequently, traditional methodologies are often unreliable.

Simulation software offers the opportunity for scenario planning when dealing with the unknown, or when you cannot rely on things to go exactly as planned based on the historical data. This makes it an invaluable tool in healthcare settings.

NHS Sheffield are among the many health trusts to deploy hospital simulation software for this very reason.

Handling the patient backlog

NHS Sheffield is now using Simul8 to help prepare a business case for overhauling its treatment of orthopaedic patients with the creation of a new unit in a new location.

In its current setting, the unit had been struggling to meet demand, even before the pandemic, but since covid, the backlog has greatly multiplied. “There is a massive queue of patients to be dealt with,” said Jill Lomas, the programme manager. The trust needed to rethink the resources available. An opportunity arose with a new site being identified where they could completely redesign how patients could flow through the system.

Where previously the orthopaedic unit was located over many floors, and co-located with A&E, interruptions in service were a common challenge. Staff may be redeployed to assist other nearby teams when demand levels rose and, overall, the unit had developed over time without the opportunity to design it with maximum efficiency of patient flow in mind.

A new facility was identified at the trust’s Royal Hallamshire hospital where everything could instead be situated on one floor, including its four operating theatres, and as a part of a self-contained unit.

With this rare opportunity to redesign the unit from scratch, the question would be how to provide staff with the best possible facility to enhance the delivery of patient services.

Optimizing workflows

The trust is now assessing how workflows can be handled within the new facility. Lomas said that the trust has used software from Simul8 to work with the orthopaedic team to assess how the theatres could increase the volume of patients treated, for example. “Our aim is to create the best possible pathways for our patients, uninterrupted by acute pathways and the impact of covid,” she added.

Lomas had one big advantage: she has used the software before and was fully aware of its capabilities. “What I really like about it is that when we have new pathways going in, there are so many variables and it’s hard to understand the situation when you’re surrounded by chaos.”

She said that she had thought of using traditional datasets, but these weren’t sophisticated enough. “What I was looking for were dials that you could twiddle and get answers at the drop of a hat so that we could evaluate our ideas and maximize the success of the implementation. There are no other tools that give us the ability to fully understand our model and its capacity constraints.”

The use of Simul8 will assist the logistics of patient care, enabling the trust to ascertain the number of patients that could be placed in critical units, and which could be placed in day care.

Planning for the future is notoriously difficult, but Simul8 can make accurate projections of the demands that will be placed on the new unit: how many beds needed; how many patients can be passed through the four operating theatres etc.

Scientific mindset

“If I want to know the number of day care units, for example,” said Ben Brewis, operations director at the trust, “it’s easy to plug in some variables. It gives us a good grasp of the numbers. And that’s something that’s important – Simul8 works really well when presenting our case, as doctors come with a scientific mindset, and they want to see the data.”

“It may be something of a step into the unknown, but Simul8 is brilliant for future planning as it offers guarantees that we can build an accurate picture of what to expect.”

Ben Brewis, Operations Director

It’s hard to see any advantages in covid, but there’s little doubt that the trust has used the pandemic to start afresh. “With the new site available, we have a fantastic opportunity to redesign our service in line with what we know our patients need,” said Brewis. “It may be something of a step into the unknown, but Simul8 is brilliant for future planning as it offers guarantees that we can build an accurate picture of what to expect, and then optimise it. And when dealing with patient care you simply cannot afford to take risks and use guess work. Through the use of Simul8 we are able to eliminate this.”

Hospital simulation software – how does it work?

Tom Stephenson, head of simulation excellence – healthcare at Simul8, who has been working with NHS Sheffield, explained how healthcare simulations work: “By breaking down everyday processes into numerical information – things like waiting times, bed capacity, staff shift patterns, patient prioritisation, floorplans, typical timings for surges in demand etc. – it’s possible to create digital replicas – or digital twins – of a multitude of hospital processes. Simulations can then be run to instantly test different configurations and outcomes to find the most optimal approach.”

With the NHS facing increasing challenges in managing the backlog across the board, exacerbated by the pandemic, simulation offers an innovative approach that can identify key solutions and then provide the evidence needed to fast-track their implementation, just as NHS Sheffield are now exploring.

Stephenson concluded: “When you think about the overall backlog, it’s not a simple problem to solve. You can’t map out the entire NHS and apply a generic fix. Instead, you need to take a more forensic approach and drill down into individual processes to find where refinements can be made. However, with so many variables at play it is not often that straightforward.

“The job of simulation is to not only highlight where the issues might not have been captured before, but to then take it to the next stage by demonstrating the positive impacts of the best possible fix.”

Learn how healthcare organizations around the globe are making informed decisions, improving systems of care and maximizing resources using our powerful simulation software.