Developing a Discrete-Eevent Simulation Model for Improving the Quality of Services: A Case Study in Urology Unit at a Kidney Center
Volume 9, Issue 3, Autumn 2019, Pages 244-260
Reza Mokhtarian Daloi, Bakhtiar Ostadi
Abstract
The length of waiting time is considered as a key determinant of patient satisfaction level; besides, it has a significant impact on the effectiveness and quality of services which are provided to patients. In addition, Simulation study is also considered as an effective tool for improving patient flow, reducing waiting time and increasing patient satisfaction. Hence, in the present study we made use of simulation to improve the quality of health care in a urology unit which is a part of a kidney center in Tehran. Put differently, the aim of the current study was increasing the efficiency of Extracorporeal Shock Wave Lithotripsy (ESWL) method besides reducing the waiting times and the patient cancellation rates. Therefore, a Discrete-Event Simulation model was developed using iGrafx software, which was later used in conjunction with MATLAB software to form and evaluate the urology unit improvement scenarios in three categories: changing technicians’ presence schedules during different shifts, changing the schedule of patient visits, and examining the factors that reduce the patient cancellation rate. The greatest differences were resulted from the employment of scheduling scenarios of patient visits on waiting time and duration of stay with averages of 23.33 and 22.81 minutes, respectively. In addition, the results of examining the factors that reduce patient cancellation rate demonstrated that the number of cancellations were decreased with an average of 1.44 cases per day. In each category of proposed scenarios, applying changes based on the selected scenario of that category led to significant improvements in performance criteria of the urology unit. It is also worth mentioning that the impact of scheduling scenarios of patient visits was much higher than other scenarios.