Modelling as an innovation tool Modelling as an innovation tool - - PowerPoint PPT Presentation
Modelling as an innovation tool Modelling as an innovation tool Digital methods for better decisions Digital methods for better decisions Ian Gibson and Peter Bodon of Digital methods for better decisions Modelling as an innovation tool
Digital methods for better decisions
Digital methods for better decisions
Digital methods for better decisions
Digital methods for better decisions
Health
Digital methods for better decisions
Limits of current methods: Benchmarks, rules of thumb – relevance with rapid change???
Fragmented consideration of facility design
information and communications technology Lean methods Quality management Models of care – limited consideration of resources, variability. Oversimplification Health is a complex system that is dynamic, interdependent, variable and resource dependent. Health relies on communication and information flows.
Digital methods for better decisions
Digital methods for better decisions
(Reference: A 36-Hospital Time and Motion Study: How Do Medical-Surgical Nurses Spend Their Time? The Permanente Journal/ Summer 2008/ Volume 12 No. 3)
Digital methods for better decisions
Approach is a design method using: Systems thinking Data analytics Computer simulation Project management Change management Facilitation Enables
Thorough understanding of current system and likely future demands. Testing of the options – “what if scenarios” using same criteria as finished facility – before design is complete
Digital methods for better decisions
Computer simulation uses mathematics and logic to construct virtual models of real systems. The models enable understanding of the system and experiments to develop optimised systems. Car crash performance
“Computer simulation is this mind-blowing advance that will increase the rate of innovation.” - Bill Gates
Digital methods for better decisions
“Computer simulation is this mind-blowing advance that will increase the rate of innovation.”
Digital methods for better decisions
References on systems engineering approaches in healthcare
Building a Better Delivery System: a New Engineering/Health Care Partnership. Proctor, P., et al., et al. Washington D.C. : National Academy Press, 2005. President’s Council of Advisors on Science and Technology. Report to the President Better Health Care and Lower Costs: Accelerating Improvement through Systems Engineering. Washington D.C : s.n., 2014.
Digital methods for better decisions
Digital methods for better decisions
Healthcare delivery system
Logistics Medical Technology Staffing Communications technology Operating protocols Patient journey Metrics Facilities People People
Performance Dashboard
Evaluate options using same parameters for full scale operation.
PSA enables better decisions by using Predictive Simulation and Analytics.
Digital methods for better decisions
Experiment in a risk free space
The solution The model The solution at the model level The real world The world of models
Risk free experimentation
Digital methods for better decisions
For
ight Valu lue
Prescriptive
Business outcome
Search for best outcome / predict ‘real world’ performance potential for unseen system configurations > Identify best course of action (local or across a value chain) Predict or classify outcome based on past performance > Focus decision making / support Structured detailed analysis of past performance > Identify factors and causes (typically local)
Simulation and Optimisation
Predictive Diagnostic Descriptive Aggregated and consumable data > Understanding past performance
– Not technology applications
Lean, 6 Sigma, TOC methodologies
system design
Digital methods for better decisions
Model of innovation
Source: Diffusion of Innovation in Service Organisations: Systematic Review and
al., et al. 4, s.l. : Blackwell Publishing, 2004, The Milbank Quarterly, Vol. 82, pp. 581-629.
Digital methods for better decisions
Organise stakeholders and decision -makers Experiment to create better system Develop and evaluate design
Model existing system Agree brief for schematic design Implementation planning
Digital methods for better decisions
Technical specialists Computer Simulation Engineers Project Managers Clinicians and Managers
Interaction enabling exceptional healthcare
Stakeholder relationships
Digital methods for better decisions
Digital methods for better decisions
Patient data for 41 months – 161,000 attendances
Digital methods for better decisions
Average arrivals per hour for all attendances peak at 8 – 9 arrivals per hour between 10:00 and 20:00 But what are the peak arrival rates???
Digital methods for better decisions
Peak arrivals per hour for all attendances peak at 11 – 21 in a range between 18 and 22 arrivals per hour
Digital methods for better decisions
Digital methods for better decisions
Attendances per annum Patient groups
Urgency category Paediatrics 15 - 34 35-65 Over 65 Total 1 53 99 137 159 449 2 779 1,296 2,410 2,241 6,725 3 2,728 4,198 4,635 4,002 15,562 4 5,857 7,485 6,166 3,537 23,044 5 650 1,103 803 240 2,797 Total 10,067 14,181 14,151 10,179 48,577
Treatment stream
Resuscitation 53 99 137 159 449 Paediatrics 10,013 10,013 Emergency 1,296 ,410 2,241 5,946 Acute 4,198 4,635 8,832 Short stay 7,539 7,539 Fast track 8,588 6,969 240 15,798 Total 10,067 14,181 14,151 10,179 48,577
Digital methods for better decisions
Factor Number Number of patients 10,013 Ambulance arrivals 6% Private arrival 94% Police arrival 0.1% Admitted 14% Discharged 86% Hours of day Distribution Parameter 1 Parameter 2 00 to 6 Negative binomial 4 0.918 7 Negative binomial 8 0.956 8 to 15 Negative binomial 13 0.907 16 to 21 Negative binomial 32 0.943 22 Negative binomial 84 0.896 23 Negative binomial 6 0.871
00:00 to 6:00 7:00 8:00 to 15 16:00 to 21:00 22:00 23:00 3 patients per hour
Digital methods for better decisions
Digital methods for better decisions
Communications data
Saturday)
Digital methods for better decisions
Digital methods for better decisions
Fast track patient - consultation
Digital methods for better decisions
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Digital methods for better decisions
reasonable representation of reality.
performance (brown line) with the result of the model performance.
with the model of 79%
park
Modelled current NEAT without improved communications technology Actual NEAT
Digital methods for better decisions
Digital methods for better decisions
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Digital methods for better decisions
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Communication Description Face to Face Direct person to person communication – both people in the same location Centralised data exchange Delivery or collection of information at a prescribed location (eg. Computer entry at fishbowl) Distributed data exchange Delivery or collection of information at the point of activity (eg. The use of mobile devices (table / phone etc.)) Direct messaging Sending / receiving information via asynchronous electronic methods (eg. Text or IM, message boards etc.) Mobile communications Direct communications in which both parties are engaged but not necessarily in the same location (eg. Mobile phones, video calls etc.)
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Technology mix scenario 1 2 3 4 Face to Face 65.0% 60.0% 57.0% 53.0% Centralised data exchange 31.0% 25.0% 20.0% 14.0% Distributed data exchange 0.0% 10.0% 16.0% 21.0% Direct messaging 1.0% 1.5% 3.0% 7.5% Mobile communications 3.0% 3.5% 4.0% 4.5%
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Digital methods for better decisions
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Digital methods for better decisions
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Digital methods for better decisions
benefits
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Digital methods for better decisions
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Peter Bodon
peter@predictivesimulationanalytics.com 0407 048 899
Ian Gibson
ian@predictivesimulationanalytics.com 0423 843 697