Balancing and optimization using simulation modeling in healthcare services

Abstract

The emergency department in every hospital deals with life and death situation every day. However, due to non-value added activities, long queues and inefficiency in treatment for patients are increased. The application of lean techniques and simulation is implemented to improve the efficiency in emergency department of Tunku Fauziah Hospital. Method of investigation used here is the DMAIC (Define, Measure, Analyze, Implement and Control). A definition of the emergency department of Tunku Fauziah Hospital and how it works are first understood followed by scrutinizing the scenario in the department while measuring and collection appropriate data. The existing problems in the current state of emergency department that slows down the entire treatment process are identified and analyzed using Arena Simulation and value stream mapping. Lean techniques of line balancing, kaizen and cellular manufacturing concept are utilized to improve the emergency department system. The future state of emergency department is modeled and simulated using Arena Software indicating a positive improvement. Upon improvement, control has to be performed in the emergency department but due to the critical policy of hospital, the project only ends with a proposal of improvement for the hospital and not actual implementation and control. The result from application of lean techniques and simulation is that the cycle time of the patient’s process flow has been reduced 57.45% from an average of 29.85 minutes to an average of 12.702 minutes. This result has clearly indicated that appropriate application of lean techniques and simulation has improved the emergency department flow as well as its efficiency in treatment through waste elimination. With proper techniques and application, lean tools and simulation are proven to benefit not only the manufacturing plant but also the healthcare services.