Simulation of Hospital Expansion and New Layout

We have not one, but two hospitals who are planning a building expansion. One has 3,000 employees and 600 beds. The other has 2,000 employees and 450 beds. Part of the expansion is a plan to move some outpatient clinics to the ground floor to reduce vertical movements that are currently a bottleneck.

The purpose of the project is to simulate ground floor traffic during a typical day with the proposed layout to identify potential problems and opportunities for improvement. To do this, we had to collect information on all the flows of people who pass through the ground floor, even if it's just to take a flight of stairs or an elevator or to take a break outside. There are 15,000 trips during one typical day and they are all reproduced in the simulation.

The FlexSim model itself is a collection of origins (where people are created) and destinations (where they are deleted) and a long list of trips with their own characteristics (type, speed, time, etc.) organized in an Excel table. This method of building the model logic is very flexible as we can simulate a completely different day of operations just by changing the data in the table.

A view of one portion of the FlexSim model where we see:

• People waiting in front of an elevator

• A patient on a stretcher

• An employee pushing a cart

• A waiting line representing a waiting room (upper right)

• Shirt colors have meanings.

• The floor markings are an imported AutoCAD layout.

The effort required for this project was 300 hours of work for two hospitals including:

1. Data collection coordination, compilation and conversion

2. Building the 2 FlexSim models

3. Meetings to discuss results

Results and lessons learned

Both hospitals had specific challenges that were identified and resolved with the help of the simulation. The simulation identified bottlenecks in the new layouts which guided changes and improvements to be made before starting the actual physical work.

Examples of changes identified and tested with the simluation: adding an alternate entry door to a central area, adding information screens to guide patients and visitors to reduce wrong directions, adding a centralized check-in area, swiping the position of 2 areas, widening a corridor.

The biggest challenge was data collection because every single employee and patient goes through the ground floor no matter where they are going or coming from. To achieve this, we had interviews with managers on all levels as well as questionnaires to fill but it still took about 3 months to obtain all information and data.

Contrary to a factory where managers are few and clearly organized hierarchically, an hospital org chart is much more complex with diverse management roles and all these people are not all readily available for meetings with a consultant. This needs to be taken into consideration when planning a project in such an environment.