Pathology Workflow Design using SIMUL8

Discussing the need, advantages and value of using SIMUL8 in Anatomic Pathology.


On April 21, Brittany Hagedorn and I, presented a webinar about the need, advantages and value of using SIMUL8 in a highly variable and complex workflow of Anatomic Pathology, particularly the Histology Laboratory. This area of Healthcare has little to no standardization or standardized processes (each lab is Laboratory Developed Test) and, of course, struggles to create change to improve and effectively address patient demanded outcomes.

Bill DeSalvo


Anatomic Pathology is really no different than many other areas of the laboratory, or healthcare.  There are struggles to change processes, implement automation and ultimately, improve the process. Complexity, variability, disruption and interaction of differently trained and competent staff is a normal and everyday occurrence. Couple those concerns with a shortage of staff, little to no time devoted to making the difficult and often costly decisions required affecting quality, productivity and reliability and anyone can understand why the struggle is almost unendurable.


Why Process Simulation in Anatomic Pathology?

  • Anatomic Pathology’s Variability, Disruptions and Interaction Complexity, demands Data Driven Solutions
  • Process Simulation provides “What If?” modelling configured with appropriate logic
  • Testing in the Virtual Environment leads to Smarter Decisions without cost or risk to patient
  • Process Simulation Insight provides understanding of the Dynamics and Interconnections of Complex Processes


The real issue, and most importantly the value, of applying Process Simulation in this area, is the difficulty of management, pathologists and staff to visualize the entire process, understand the complexity and develop a business case without creating patient risk.


Risk is the BIG stopper to change

Most laboratories have an “acceptable” process allowing the pathologist to confidently produce a diagnosis (clinical outcome). Rightly so, labs are very concerned with the “What If’s” when making any change to the process. Conversely, management sees the value of changes and pushes change to increase productivity, reduce cost and improve quality (Operational outcome).


All have been exposed to the concept that LEAN and Six Sigma principles drive improvement. Until now, there is disagreement on the static information generated and used, everyone has an anecdotal story about how the process change worked or did not work – Stalemate. In addition, it is difficult to get commitment of time, effort and money (especially when there is no consensus on the outcome) and very little to no data to support.


Enter tried and true Process Simulation

Replicate the current state; identify all the required variables to build a comprehensive business case; capture quantifiable and non-quantifiable factors; expected business benefits; process options and effects on cost. Key aspects of the process change can be tracked and quantifiably measured at will. Process Simulation provides the ability to visualize current and proposed future state, to assist all parties involved to identify what changes should be made.


Process Simulation does not stop there – Continual management of process compliance and change factors can be tracked and measured, identifying clear and concise real time measurement of achievement. Histology Laboratories no longer have to fight change and their ineffective workflow. They can visualize what change will bring, concentrate on quality improvements and meeting the patient demands. Goals Realized!


Now is the time to move process improvement to the next level. Combine static information with tailored metrics and you get Process Simulation Modeling. Anatomic Pathology can no longer sit at the edge of quality improvement and continue to effectively and accurately function in the growing and changing healthcare environment. Management demands, employees demand and Patients assume we are at a higher, controlled and managed level of quality than we are. It is time to meet the Patients current expectations and create a process that is flexible to maintain gains in Quality. Process Simulation is Process Improvement for Anatomic Pathology.


William DeSalvo

William DeSalvo

William DeSalvo, President of Collaborative Advantage Consulting LLC, has 39 years of experience in the Research/Clinical Anatomic Pathology laboratory as a Histotechnologist (HTL ASCP) and trained in Six Sigma and LEAN methodologies for process improvement. He is a successful consultant and educator to Anatomic Pathology Laboratories, located in the USA, Europe and Russia, concentrating on workflow and workload assessment, reorganization and implementation of standardized processes and test utilization.