Identifying Areas for Operational Improvement and Growth in IR Workflow Using Workflow Modeling, Simulation, and Optimization Techniques.

Identifying areas for workflow improvement and growth is essential for an interventional radiology (IR) department to stay competitive. Deployment of traditional methods such as Lean and Six Sigma helped in reducing the waste in workflows at a strategic level. However, achieving efficient workflow n...

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Published in:Journal of Digital Imaging Vol. 34; no. 1; pp. 75 - 85
Main Authors: Tellis, Ranjith, Starobinets, Olga, Prokle, Michael, Raghavan, Usha Nandini, Hall, Christopher, Chugh, Tammana, Koker, Ekin, Chaduvula, Siva Chaitanya, Wald, Christoph, Flacke, Sebastian
Format: algorithm research tables/charts Journal Article
Published: Springer Nature Feb2021
Online Access:View this record in EBSCOhost
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      dt: Feb2021
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s10278-020-00397-z
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        atl: Identifying Areas for Operational Improvement and Growth in IR Workflow Using Workflow Modeling, Simulation, and Optimization Techniques.
      aug:
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          Tellis, Ranjith
          Starobinets, Olga
          Prokle, Michael
          Raghavan, Usha Nandini
          Hall, Christopher
          Chugh, Tammana
          Koker, Ekin
          Chaduvula, Siva Chaitanya
          Wald, Christoph
          Flacke, Sebastian
        affil: Philips Research North America, 222 Jacobs St, 02141, Cambridge, MA, USA
      sug:
        subj:
          Radiography, Interventional
          Simulations
          Workflow
          Human
          Electronic Health Records
          Tomography, X-Ray Computed
          Workforce
          Radiologists
          Models, Theoretical
          Descriptive Statistics
          Patient Care
      ab: Identifying areas for workflow improvement and growth is essential for an interventional radiology (IR) department to stay competitive. Deployment of traditional methods such as Lean and Six Sigma helped in reducing the waste in workflows at a strategic level. However, achieving efficient workflow needs both strategic and tactical approaches. Uncertainties about patient arrivals, staff availability, and variability in procedure durations pose hindrances to efficient workflow and lead to delayed patient care and staff overtime. We present an alternative approach to address both tactical and strategic needs using discrete event simulation (DES) and simulation based optimization methods. A comprehensive digital model of the patient workflow in a hospital-based IR department was modeled based on expert interviews with the incumbent personnel and analysis of 192 days' worth of electronic medical record (EMR) data. Patient arrival patterns and process times were derived from 4393 individual patient appointments. Exactly 196 unique procedures were modeled, each with its own process time distribution and rule-based procedure-room mapping. Dynamic staff schedules for interventional radiologists, technologists, and nurses were incorporated in the model. Stochastic model simulation runs revealed the resource "computed tomography (CT) suite" as the major workflow bottleneck during the morning hours. This insight compelled the radiology department leadership to re-assign time blocks on a diagnostic CT scanner to the IR group. Moreover, this approach helped identify opportunities for additional appointments at times of lower diagnostic scanner utilization. Demand for interventional service from Outpatients during late hours of the day required the facility to extend hours of operations. Simulation-based optimization methods were used to model a new staff schedule, stretching the existing pool of resources to support the additional 2.5 h of daily operation. In conclusion, this study illustrates that the combination of workflow modeling, stochastic simulations, and optimization techniques is a viable and effective approach for identifying workflow inefficiencies and discovering and validating improvement options through what-if scenario testing.
      pubtype: Academic Journal
      doctype:
        algorithm
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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