Posted: April 8th, 2015
Business simulation with Arena and excel;Improving NHS Organisations;
The Scenario Description
?The challenge for improving NHS organisations is stronger than ever. Issues such asexpanded access to NHS, a growing aging population, technological advancement, and therise of the price of NHS services have placed major pressures on these organisations.
?As the patient waiting problem is listed as one of the indicators of quality assurance for theNHS, improving waiting time and achieving a proper allocation of resources are put into thetop consideration and set as a top priority by the NHS.
?The NHS organisation/ medical centre service starts with patient arrival. Most patients whocome to the medical centre are based on the appointment set from the previous visit.Hence, patients who have been given an appointment are admitted to the medical centre.New patient (walk-in patient) have to go to the new patient registration desk to fill outapplication form, to show their health insurance certificate (NHS card) or other relateddocuments and will be given an appointment for another day.
?In the medical centre, several stages or phases need to be held by each patient duringtreatment period. Firstly, every patient has to go to the registration counter and give his orher appointment card to the counter staff. This helps the staff to obtain the patient’sinformation or data of the last visit.
?Patients who require a laboratory test will head to the provided laboratory and makingrelated tests. While patients who do not required performing a lab test are directed to thewaiting room near to the consultation room and wait to be called.
?There are three tests performed in the laboratory; the urine test, blood test or bloodpressure check. The patient has to do any of these tests (only 1 test) before getting aconsultation from the specialist. Once completed, the patient will be waiting at theconsultation waiting room until called. The patient’s arrangement to enter the consultationroom is based on the first in first out (FIFO) rule.
?Although the patient has a predetermine appointment, the appointment however does notspecify the required time of arrival, instead an open appointment system is applied, whichmeans that each patient is able to attend at any time within the operation time of the clinic.After finished the consultation with the specialist, patients will be waiting at the paymentcounter area to make a payment.
?Patients who are prescribed with a supply of medication by the specialist will be waiting atthe pharmacy waiting area for medical supplies. Finally, the patient will leave the system.
Data Collection and Fittings
Data were collected via stopwatch, interviewing the clinic management, staffs, and patients, reviewing the appointment-recorded files, and observing the daily operations. The data required to develop the multiphase patient flow are as follows:
?Inter-arrival times between 252 patients are:
Table 1: Sample of 252 patient random inter-arrival times
?The patients are admitted to the clinic (85%), whilst the rest to be given an appointment foranother day.
?New patient registration counter service time is Lognormal 5.5+ LOGN(8.18,4.37) whileservice time of appointed patient registration counter is Lognormal 2+ LOGN(2.02, 3,82).
?74% of patients need to perform a laboratory test.
?Laboratory test: 30% Urine, 50% Blood test and 20% Blood Pressure test
?Service time at the test laboratory: U(2,4) for Urine test, U(1,3) for blood test and U(2,4) forblood pressure check.
?Consultation inspection: Lognormal 10+ LOGN(0.875, 0.599)
?Payment: Lognormal 1+ LOGN(0.662,0.221)
?Percentage of prescribed patients: 82%
?Pharmacy: Lognormal 15+ LOGN(0.712, 0.312)
There are two doctors allocated for the clinic per week. Five nurses are scheduled for working at the clinic. Two nurses are allocated at the registration counter (one nurse at appointed patient registration counter, whereas the other nurse allocated at the new patient registration counter), only one nurse allocated at the test laboratory. One nurse and two doctors including specialist are allocated at the consultation room. One nurse at the payment counter, one nurse and pharmacist at the pharmacy counter. See table 2 for the medical resource allocation plan.
Table 2: the medical resource allocation plan
New Patient Registration
The Coursework Tasks
For this piece of individual coursework, you are required to apply simulation modelling to deliver the tasks below:
Task 1- Provide an Introduction to the problem including: problem brief, main aim, objectives, tools and techniques, and key performance indicators.
Task 2- Use the tabular form to define and analyse the NHS organisation problem. This analysis includes decomposing the system being investigated into its main components including: entities, attributes, activities, state variables, and events.
Task 3- An appropriate flowchart with detailed explanations.
Task 4- Obtain the best fit of patient inter-arrival times using the Input-Analyser tool.
Task 5- Develop a business simulation model to imitate the above security check system (“As-Is” situation). Five simulation runs are required, at least two experiments (scenarios) to:
i.Reduce the overall simulation time.
ii.Achieve a reduced queue at each service facility.
iii.Increase the resource(s)/ service facility(s) utilisations.
iv.Reduce average waiting time.
A comparison via Excel diagrams of the “As-Is” scenario with any other improvement scenarios “What-If” is required.
Task 6- Conclusion and Recommendations for further improvement (bullet points)
?This assignment has to be completed as an individual project.
?You will need to adopt the report structure provided below, use examples and cases from text books, journals, papers and reports to support your arguments and reference properly, using Harvard Reference Style
?The structure of the report (the outlines below have to be linked with the coursework tasksabove):
– Title page (To include report title)
– Table of contents
– The main body of the Report including
oThe logical diagram (flowchart) including why this flowchart, the flowchartdiagram and explanation.
oThe Distribution fitting, reason behind this fitting, the best fit, all comparison,and explanation.
?Description of the “As-Is” model
?Excel results of each KPI
?Analysis and discussion
?Description of each “What-If” scenario
?Excel results of each KPI
?Analysis and discussion
?Overall Excel chart comparisons between “As-Is” and “What-If”Scenarios
oAppendices (if found)
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