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Healthserv Los Baños Medical Center

Inpatient Admission and Discharge Simulation

May 2, 2016

Patricia Bianca R. Asis, Christian B. Balanquit, Geraleen Nicole I. Gaytano,


Maria Jenelle Rose L. Melanio | UPLB IE 144 (Systems Simulation) YZ – 3L

INTRODUCTION

Company Background
HealthServ Los Baños Medical Center was established in 2002 as an outpatient
facility offering multi-specialty and diagnostic medical services. It housed the automated
equipment and expertise necessary to conduct outpatient chemotherapy, cataract surgeries,
minor operations, and dialyses. In 2010, as the medical staff grew in number and the
equipment became modernized, HealthServ opened a three-level hospital – accredited in
2011 as a “Center of Excellence” by PhilHealth. In 2016, the building further expanded with a
modern four-floor Medical Arts Building for outpatient services.

Currently, the hospital is a 78-bed tertiary facility (expandable to 85 beds) with a 3-


bed ICU, 9-bed dialysis center, intensive care unit, emergency room, operating room
complex, heart and lung station (which includes a 2D echo, and stress test), a tertiary
laboratory with microbiology capacity, x-ray, ultrasound, CT scan, and mammography.

Problem Being Addressed by the Study


It was observed that there is a continual shortage in rooms for admission, and
patients have to wait in the emergency room for a considerable amount of time before being
admitted. These delays are closely related to the discharges of previous room occupants.
Contributing factors will be discussed in system documentation and preliminary input
analysis.

Objectives
The study generally aims to minimize delays in room admissions and discharges.

With the current data, the specific objectives so far are:


 To determine the number of beds that would minimize delay in admission; and

 To determine the number of servers in the Billing Department that would minimize
delay in discharge.
HEALTHSERV LOS BAÑOS SYSTEMS PROCESSING

Figure 1. Flow of Arrival and Discharge Processes

A patient is given first aid upon arrival at the Emergency Room, and he waits
there until a bed in a room is freed up for admission. Delays of transfer may result
from waiting for laboratory results and from uncontrollable factors such as waiting for
the patient’s vital signs to stabilize and waiting for the patient to make a decision if he
wants to be admitted or not.

The patient is then admitted into a room, spending the suitable amount of time
to be cared for at the hospital. When he is deemed well enough, the consulting doctor
gives a notice of discharge, signaling that the patient may already leave. After
receiving this discharge notice, the Billing Department prepares the final complete bill
of the patient, which is paid for at the Cashier before actual discharge from the
hospital.
PRELIMINARY INPUT ANALYSIS

Figure 2. Distributions of Inputs and Outputs


Figure 3. Preliminary Model
OUTPUT ANALYSIS

The preliminary model reflected the following evident problems:

Limited number of beds in ER


Failed arrivals due to insufficient capacity amounted to 92 inpatients and outpatients
in the total simulation time of 544.15 hours.

Limited number of Rooms


As the data are all interconnected from admission to discharge delays, it can be
inferred that the 78-bed capacity is not enough to cater the demand. Results show that the
rooms are full 50.64% of the time.

Delay in transfer from ER to Rooms


A queue was designed to hold transfers of inpatients from ER to Rooms. From the
results, its percent occupied is 49.49%. Thus, there are evident delays in admitting, causing
long waits to inpatients half the time – an alarming rate especially for urgently needed
admissions. The performance measure and target improvement involves lessening this
49.49% to 0-5%.

LIMITATIONS OF THE PRELIMINARY MODEL

1. The entities would not enter the Payment and Guard locations (programming error)
2. Data gathered on the processing time of inpatients in the ER are not enough to fit a
distribution (limited data, further data gathering needed)
3. Resources are not yet utilized, thus delays from unavailability of doctors and nurses
are not yet taken into account (programming error)

Format Reference:
Bates College (2011). How to Write a Paper in Scientific Journal Style and Format. Retrieved from
http://abacus.bates.edu/~ganderso/biology/resources/writing/HTWsections.html

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