Leveraging Lean Principles and Simulation Optimization for the Healthcare System Design Problem

Abstract

The healthcare spending has been increasing due to a growing population In response to the rising cost the government and hospital are to increase efficiency Efficient allocation of healthcare system involves planning and coordinating several resources One of the most expensive and highly specialized is considering the emergency care which is critically important to the seriously ill and injured patients The injuries are the number one killer of people between the ages 1 to 44 Therefore improving the emergency care system has potential not only to decrease the cost but also faster access to the care Lean which adopts the principles of the Toyota Production System (TPS) is a systematic approach for identifying and eliminating non-value-added activities through continuous improvement by crossing multiple departments derived from patient requirements This research applies Lean principles and explores the healthcare system problem by proposing specific design procedures for the problems of emergency department (ED) laboratory test and operating room (OR) First the crisis of overcrowding in ED is a very important issue worldwide To ensure that ED patients receive prompt attention and timely treatment especially under dynamic and stochastic demands most countries use triage scoring to prioritize ED patients according to their clinical urgency The triage process based on the emergency severity index (ESI) system and current layout design cause the phenomenon of sequential batch processing The average time of a patient in a queue will increase because of the variability of the batch Most patients will still not meet the requirement of timely care Second laboratory results are essential for physicians to diagnose medical conditions Because of the critical role of medical laboratories an increasing number of hospitals use total laboratory automation (TLA) to improve laboratory performance The system becomes congested during periods of peak demand The cycle time usually exceeds the lead time during the peak time Third surgery assignment must balance capacity utilization and demand so that the arrival rate does not exceed the effective production rate However authorized overtime increases because of random patient arrivals and cycle times This research is based on value stream mapping (VSM) for the design and analysis of the ED TLA and OR Subsequently this research investigates the methodologies to improve the performance With increasing technological advances in the medical industry patients will continue to care not only about the quality of service but also about the efficiency of treatment Therefore ways to shorten patient waiting time and improve patient satisfaction becomes a very important issue for hospitals

Date of Award	2015 Mar 10
Original language	English
Supervisor	Ta-Ho Yang (Supervisor)