Introduction
FloInsights Simulator (FloSim) is an innovative tool designed to simulate the operations of hospital clinics using extensive datasets and years of industry expertise. This powerful capability allows us to enhance clinic throughput through remote simulations, requiring only a floorplan, patient pathway information, and staff availability.
Recently, we collaborated with CentroMedico Ophthalmology Clinic in Chiasso to explore how we could optimise their operations and boost capacity. Utilising our proprietary Simulation tool, we were able to create a digital twin in which the clinic’s patient capacity was increased by 46.15% and the average time each patient spent in the clinic was nearly halved (Figure 1). This blog post delves into how we arrived at these conclusions and the steps we took.
Figure 1: Using our Simulator as a Digital Twin for the CentroMedico Ophthalmology Clinic in Chiasso, we were able to increase the clinic’s capacity by 46.15 % and reduce the length of patient journey by 45.67 %.
Simulator
Overview of the Process
Our engagement followed a multi-step process to validate the accuracy of the Simulations and ensure any proposed changes were legitimate and feasible. The steps included:
- A discovery document to gather information on the current state of the clinic; the floorplan, staffing levels and patient pathways.
- Simulating the current working environment (Base Scenario)
- Proposing the changes to the Chiasso Clinic and verifying their feasibility
- Simulating the proposed changes to determine what improvements could be accomplished
Base Scenario
The Chiasso clinic operates with 3 members of staff (Technician, Nurse and Doctor) whose responsibilities vary due to their respective qualifications. All patients follow the same pathway in which their eyes are imaged using Optical coherence tomography (OCT) by a nurse, then proceeding to an Injection suite where a Technician prepares them before a Doctor administers an Injection.
We simulated the clinic’s current operations with (on average) 13 patients being treated within a 2 hour session. The results of our simulations identified two areas in which we could target in order to facilitate improvements in the clinic’s capacity and throughput; a bottleneck at the injection stage of a patient’s journey and an inefficiency in the current appointment schedule. This is depicted in Figure 2 (below), in which we can see that, whilst there is still space for additional OCT images to be performed (A, left image), there is minimal space available for additional Injections (A, right image). Furthermore, we can see from Figure 2B that as the clinic session progresses, on average the patients’ respective journey times increase; indicating a potential inefficiency in the appointment schedule.
Figure 2: The clinic currently has additional availability to perform more OCT images (A, left image) but is limited by the availability in the Injection suites (A, right image). We also identified that the length of the patient journey increases the later in the session their appointment is scheduled.
Proposed Scenario
After analysing the results of our initial simulations we agreed with the team at Chiasso that we would use our Simulator to determine what improvements they would see if they were to make the following 2 changes:
- Spitting the Injection suite into 2 distinct spaces (Figure 3), with the Technician and Doctor rotating between patients to prepare them and perform the Injection, respectively.
- Optimising the appointment schedule
Figure 3: The current Chiasso Clinic floorplan (A) shows they have a room for performing OCT imaging and a room for performing injections. One of our proposed changes (B) was to split the injection suite into 2 distinct areas.
When we simulated these changes with the same number of patients, we saw a drastic increase in availability of Injection spaces from 10.4% (Figure 2A, right image) to 40.7% and the wait times for Injections being almost completely removed, coming down from 19:25 ± 13:06 minutes to 1:56 ± 1:09 minutes. Both of these clearly confirmed that the bottleneck at the Injection stage had been removed.
However, the above results were to be expected given we have effectively doubled the number of injection suites, the real question was what capacity increase would this allow and how would this affect the patient’s overall experience with respect to their total journey length?
By iteratively increasing the number of patients, we determined that the maximum capacity in which the proposed changes could consistently cope with was 19 patients per day; a 46.15 % increase. Beyond this, the session would occasionally over run.
Furthermore, we observed that despite almost 50 % increase in the number of patients in the clinic, the patient experience was not adversely affected, in fact the proposed layout changes alongside an optimised appointment schedule resulted in a significant reduction in the average patient journey time from 57:48 ± 12:50 minutes to 31:23 ± 7:26 minutes (Figure 4, below).
Figure 4: Despite a nearly 50% increase in clinic capacity, the patient experience should be improved as the average journey times are reduced in the proposed changes (B) compared to the current clinic setup (A).
Conclusion and Future work
Using our proprietary Simulation tool we created a digital Twin of the CentroMedico clinic in Chiasso in which we were able to increase clinic capacity by approximately 46%, while also enhancing the patient experience by reducing average journey times.
We are continuing to work with the clinic in Chiasso to first verify that our proposed changes have the desired results when implemented in the ‘real world’ and then to continue to identify ways in which we can help them improve going forward.
We are continuing to develop the FloInsights Simulator, and whilst it is currently being utilised in healthcare for hospital clinics, we believe it has the potential to be utilised in a variety of other sectors. If you are interested in finding out more or see an opportunity of where we can work together, please do get in touch with us by dropping us an email at: info@floinsights.com