SimLean EducateInterlude 1 – Level the Load

Using an example of a generalised simulation of a

theatre process

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The generalised Day Case theatre process

Run the model »

2 batch

Day 1 Day 2Day 3

Day 4 Day 5

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Patient flow: 2 Batch

Patient profiles: 2 Batch

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6

Holding - 32 minutes

Discharge - 46 minutes

Average Queue Times

Reception -14 minutes

Patient queueing times: 2 Batch

Level the Load?

Let’s look at spreading arrivals across 6 batches

Sounds scary?

How about a small change:• Patients arriving at 8:00, 8:30, 9:00• Patients arriving at 13:00, 13:30 and 14:00

7Run the model »

6 batch

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• The number of patients on the premises is never more than 17 (compared to 24 under 2 Batch)

• Fewer morning patients remain in the system at 1pm (less stress on staff and patient)

• Little effect on departure pattern as same amount of work to be done

2 Batch

6 Batch

Impact on Patient flow

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6 Batch2 Batch

In treatment 79 mins 79 mins

Waiting 77 mins 52 mins

Blocked 34 mins 30 mins

Visit times 190 mins 161 mins

Averages

2 Batch 6 BatchImproved patient

value

Comparison of Patient profiles

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Improved patient

value 2 Batch and 6 Batch13.3% booking in

Averages

2 Batch14 mins

6 Batch4 mins

Queue for Reception

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2 Batch 6 batch42% other 48%38% blocked 32%20% work 20%

Averages

2 Batch32 mins

6 Batch16 mins

Queue for Prepare and Hold

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Averages

2 Batch46 mins

6 Batch49 mins

Queue for Discharge Process

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2 Batch 6 batch35% other 37%5% blocked 3%60% work 60%

2 Batch 6 batch68% other 71%17% blocked 14%15% work 15%

Patient flow through Theatre and Recovery

Summary

• We have made a slight change toward spreading patient arrivals and levelling the load. This small change has been shown to:– Reduce patient queuing times– Reduce the number of patients on the premises

Is the principle of ‘levelling the load’ something you could use?

Do you think this small change goes far enough?

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Interlude insight

If you always do what you always did-you'll always get what you always got

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THE SLIDES THAT FOLLOW ARE FOR FURTHER INSIGHT

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Patient flow (numbers)2 Batch 6 Batch

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Does 6 Batch cause later finish times?

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Day 1 Day 2

2 Batch - Time View

Theatre finish time on Day 2

Does 6 Batch cause later finish times?

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2 Batch - Time View

6 Batch - Time View

Theatre Finish Times