Critical Path Network: Simulation shows promise for health care modeling

The use of computer simulation modeling at Overlook Hospital was really "a very simple application of a simulation model," asserts Dan Krupka, PhD, managing principal of Sherborn, MA-based Twin Peaks Group LLC. In fact, he says, the more complex the process, the greater the need for computer simulation.

"For simple processes, it is overkill," Krupka concedes. "If it’s complex, or if there’s a bunch of money or patient safety is at stake, a more quantitative approach is helpful."

Here are some questions, he says, such a simulation might answer:

  • How many beds do I really need on this ward?
  • How many people do I need for housekeeping?
  • How should I schedule them?
  • How do I manage my discharge process?

At the highest level, Krupka adds, computer simulation would be a valuable tool if you are designing a new facility. "I would certainly advise people to simulate the main processes to get a balanced flow," he points out.

What precisely does he mean by balanced flow? "For example, one of the things we are working on now with Overlook is admission cycle time — how fast it takes to get you from the emergency department into the bed. There are many variables. When you look at balanced flow, you are asking if there are significant bottlenecks between the decision to admit and getting the patient on the floor."

Another advantage of computer simulation is that it does not require any special knowledge or expertise on the part of staff. As for budget, he says, "Ultimately, it should involve financial or safety decisions. One of the challenges in health care is that you can’t really put a value on a life."