Simulation and Six Sigma in Healthcare
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Transcript of Simulation and Six Sigma in Healthcare
SIMULATION in SIX SIGMA
Abdulkadir Atalan
PhD Student
Clemson University
Department of Industrial Engineering
2014
Briefly Six Sigma
“Six Sigma is a disciplined program or
methodology for improving quality in all aspects of
a company’s products and processes.” (Source: Promodel)
Six Sigma Tools
SIMULATION
FMEA
KANBAN
KAIZEN
TQM
DOE
CAUSE & EFFECT
RISK MANAGEMENT
HYPOTHESIS
TESTING
QFD/HOUSE OF
QUALITY
ETC….
Simulation
“Simulation refers to a broad collection of
methods and
applications to mimic
the behavior of real
systems, usually on a
computer with
appropriate
software”. (Source: Kelton, 2004)
Why Simulation in Six Sigma?
Simulation is just one of the many Six Sigma software tools used during an initiative; however it is one of the most important. Within
the analyze and improve stages of the DMAIC methodology, or the analyze and design stages of the DMADV methodology, simulation is a powerful software tool because of benefits it provides. • Simulation takes into account process variances, uncertainties and
interdependencies
• Simulation can test many alternative solutions quickly and easily
• Simulation takes the subjectivity and emotion out of decision
making
• Animation features make simulation a good tool to help sell others on the best solutions
• Reusable models encourage continuous improvement
(Source: Promodel)
Simulation Application Areas
• Has been used
– Manufacturing facility
– Bank operation
– Airport operations (passengers, security, planes, crews, baggage)
– Transportation/logistics/distribution operation
– Computer network
– Business process (insurance office)
– Fast-food restaurant
– Supermarket
– Communications
• Is becoming widespread in healthcare delivery as well.
Why Simulation?
Less Expense: If we apply proposed solution scenarios
directly clinic which might be expensive such as schedule
modifications and additional bed, rooms or staff. There might
be a chaos.
What if Scenarios: Simulation has ability to test what-if
scenarios in a model of your facility.
Time Consuming: Simulation can simulate weeks worth of
operations in minutes, allowing you to quickly insight into
how proposed solutions cases can effect overall productivity
over long periods.
Provided With Statistical Analyzes: Give more detail
statistical and mathematical information which gives us high
level of confidence.
Simulation Steps
• Create Workflow Charts
• Collect Necessary Historical
Data
• Form Simulation environment
based on real physical area.
• Run Whole System into
Software one to one.
• Create possible Case scenarios.
• Analyzes results.
Simulation Software
Most common used:
• SIMUL8: Software for discrete event or process based simulation.
• Arena: Discrete & Continuous systems, 2D,3D Animation, Based
on SIMAN
• Flexsim: Discrete-event, Object-oriented simulator; developed in
C++ using Open GL, Animation: 2D, 3D, Virtual reality
• ProMod: Manufacturing Systems, Simulation & Animation (2D &
3D)
• ExtendSim: Block-diagram approach, Versions for mixed and for
continuous only, C programming language
• AnyLogic: discrete event, using
• Etc…. “ Many do have trial versions”
Case Study
We compare performance measures between the
two cases to asses the impact of the additional
activity.
Figure: Flexsim Software Screenshot
Using Distribution for Activities
Patient Arrival Patient Check-in Nurse Triage Time Patient Urine TestPhysician
Consultation Check Out
Patient Departure
Patient Arrival Patient Check-in Nurse Triage TimePhysician
Consultation Check Out Patient Departure
Process Time Assigned
Arriving Patient Exponential (0.0, 10.0, 0)
Check-in Uniform (3, 5, 0)
Triage Triangular (3, 15.0, 5, 0)
Treatment by Physician Uniform (20, 30, 0)
Check-out Uniform (3, 5, 0)
Simulation Output
Number of patients in waiting room vs. time
Resources Utilization Rate
Case Scenarios
Flexsim: Design of Simulation Scenarios
Arena: Design of Simulation Scenarios
Optimization
“Simulation is a powerful “what-if” technology that allows you to
model and experiment with several alternative scenarios so that
you can select the one that best meets your objectives.” (Source: Arena OptQuest)
Comparison of Cases
Without Extra Test
With Extra Test
Ave Patient Waiting Time (min)
Ave Patient Waiting Time in Clinic (min)
Ave Exam Room Utilization (percentage)
Note that adding a 3 minutes test can increase patient waiting
and total time 15 to 20 minutes
Conclusion
Using Simulation Tool to show
the target of Six Sigma:
• Improving patient flow process
• Decreasing patient waiting time
• Increasing patient satisfaction
• Reducing process cost
• Increasing resources utilization
THANK YOU!