I led the University of Wisconsin team to victory in the inaugural FlexSim - SHS Emergency Department Modeling Competition in 2015. This international competition was sponsored by Flexsim Healthcare and took place at the 2015 Orlando Society for Health Systems conference. The team consisted of Samuel Schmitt, April Sell, Michael Russo and myself. We were advised by Dr. Brian Patterson and Dr. Laura Albert.
This case competition involved optimizing the operations of an emergency department (ED) using discrete event simulation and operations research tools. The goal was to analyze the Susquehanna Health ED’s current operations and determine the best care delivery model to meet productivity requirements while satisfying staffing and care constraints.
We used a combination of discrete event simulation (FlexSim healthcare software), design of experiments, and mathematical programming to determine the ideal care delivery model. See below for a copy of our winning presentation.
Executive Summary
Susquehanna Health, a four‐hospital, not‐for‐profit health system, has deployed an Emergency Department (ED) Leadership Team to reduce expenses and optimize operations at their flagship hospital, Williamsport Regional Medical Center (WRMC). The Emergency Department has been experiencing pressure from a recently enacted marketing campaign that ensures patients are seen by a provider in 30 minutes or less at two competitor hospitals in the region. This campaign concerns Susquehanna Health because their current average door to provider time is 42.7 minutes with peak times as long as 140 minutes. As a result, 2.8% of their patients are leaving without being seen.
The Susquehanna Health System needs to be competitive in order to face today’s healthcare trends of declining reimbursement, increasingly high debt, and greater focus on outpatient services. The Emergency Department Leadership Team reached out to UW‐Madison’s Industrial & Systems Engineering students to assist them in creating a simulation that will help them improve patient safety, staff productivity, and overall efficiency.
The UW‐Madison Industrial & Systems Engineering students developed a discrete‐event simulation of WRMC Emergency Department’s traditional triage and bed process using FlexSim HC simulation software. Input data consisted of processing time distributions and probabilities supplied from the Emergency Department Leadership Team. To enhance the accuracy of the model, the team also collaborated with physicians at the University of Wisconsin Hospitals and Clinics (UWHC) to gather information on average processing times. Based on best practices in other institutions, simulation models were created to represent the two additional delivery methods: PITT and PITT/Super Fast Track.
After the modeling process was completed the team ran a series of experiments to determine the optimal delivery method and staffing levels. Super Fast Track appeared to be the best delivery system, however the team recommends that this analysis be redone on a more powerful machine. The machine used for modeling was not powerful enough to run the simulation experiments needed for statistical certainty.
The team views this as the first phase of a longer term project. The team will continue to refine the model and run new experiments once a new machine is procured. Collaborators at the UW – Madison, School of Medicine and Public Health, have asked the team to build a second set of models to be used for the UW Health ED.
