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Using Arena Simulation Software to Improve Healthcare Processes

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Carley Jurishica Arena US Healthcare Account Manager

Copyright © 2009 Rockwell Automation, Inc. All rights reserved.

Who am I?
Carley Jurishica 312.952.6869
• BS Industrial Engineering and Masters in Engineering Management - Northwestern University • Extensive Arena consulting and training experience • Experience in Healthcare Simulations • Developed several real-world emergency department models with Arena • Published Paper “Emergency Department Simulations: Medicine for Building Effective Models.”

Copyright © 2009 Rockwell Automation, Inc. All rights reserved.


Stephen Epstein. The panel found a system that is overcrowded. Inc. with access to emergency care declining and with poor capacity to deal with public health or terrorist disasters. The number of emergency departments has declined by 14 percent since 1993 despite an increasing number of people coming to them for treatment. Copyright © 2009 Rockwell Automation. Epstein was a member of the American College of Emergency Physicians task force that studied the nation’s emergency care. an emergency care physician at Beth Israel Deaconess Medical Center in Boston. “The emergency health care system’s in serious condition. We have a safety net for health care that is frayed. the report said. warns a new health care analysis.The nation’s emergency care system itself is ailing. All rights reserved. Their report is being released Tuesday.” said Dr. 3 . analysis finds WASHINGTON .Wake Up Call (1st ring) Emergency health care in ‘serious condition’ System in poor capacity to deal with public health disasters.

Health care professionals and engineers should work more closely together to address these challenges. outdated procedures. Copyright © 2009 Rockwell Automation. and 43 million people uninsured. Inc. costs rising at roughly three times the rate of inflation.000 preventable deaths per year. 4 . and performance in many other industries. All rights reserved. about a half-trillion dollars wasted annually through inefficiency. productivity.Wake Up Call (2nd ring) FOR IMMEDIATE RELEASE Engineers and Health Professionals Should Work Together To Address Quality and Cost of Health Care WASHINGTON -. said the committee that wrote the report.nearly 100. says a new report from the National Academies' National Academy of Engineering and Institute of Medicine. This "collective inattention" has contributed to serious consequences in health care -. health care industry has neglected engineering strategies and technologies that have revolutionized quality.S.The U.

All rights reserved. Carmel OSU Medical Center Rush North Shore Hospital St. Inc.Healthcare Customers • • • • • • • • • • • • • • • • • • • • Atlantic Health System Beaver Medical Center Borgess Medical Center Calgary Regional Health Authority Cookeville Regional Medical Center Danbury Health Systems Erasmus University Good Samaritan Kaiser Foundation Mayo Clinic Hollywood Memorial Mt. . Elizabeth's St. Paul University of Iowa York Hospital Cerner Montefiore Medical Center 5 Copyright © 2009 Rockwell Automation. Vincents (NY) Vancouver Coastal Health Authority Akron Children’s UMass Memorial Health Care Iowa Health System Bay Medical Center Beth Israel Hospital British Columbia Children's Cincinnati Children's Clinic Cooper Health System Denver Health Georgetown University Jackson Memorial Lehigh Valley McGill University Montefiore University New England Medical OhioHealth Sentara Health System St.

6 . Inc.Top 10 Strategic Technologies for 2010 Copyright © 2009 Rockwell Automation. All rights reserved.

All rights reserved. 7 .Success at Sentara Healthcare • Awarded CIO magazines top 100 Innovative organizations for use of simulation technology Copyright © 2009 Rockwell Automation. Inc.

Simulation in healthcare 3. All rights reserved.Agenda 1. Example and modeling environment 4. Overview of Arena 2. Questions Copyright © 2009 Rockwell Automation. 8 . Inc.

9 .5B Annual Revenues • 20. Inc. • Founded 1982 • SIMAN language (1982) w/ Cinema animation (1985) • Arena (1993) – Over 350. $4. All rights reserved. • US government & Peugeot are largest domestic & Int’l customers – Taught at over 900 universities worldwide • Arena textbooks in five languages Copyright © 2009 Rockwell Automation.000 users worldwide and growing. • Approx.000 Employees worldwide – The former Systems Modeling Corporation was acquired in April.Company Background • Rockwell Automation – (NYSE: ROK) – A leading industrial automation solution provider and controls manufacturer. 2000 by Rockwell.

German & Portuguese References: – Introduction to Simulation using SIMAN (Pegden. Inc. Sadowski. • • • • Copyright © 2009 Rockwell Automation.Arena in Academia • Four Arena textbooks (in English): – Simulation with Arena (Kelton. Sturrock) – Applied Simulation Modeling (Seila. Over 900 universities globally. 10 . Spanish. Shannon. Rockwell sponsors the annual IIE Student Simulation Contest. Ceric. Melamed) – Process Analysis and Improvements (Seppanen. Sadowski) – Simulation and Analysis (Kelton. Tadikamalla) – Simulation and Analysis with Arena (Altiok. Chandra) Arena textbooks also in Japanese. All rights reserved. Law) Taught at most universities that offer Industrial / Systems Engineering and Operations Research programs. Kumar. Korean.

McLaughlin and Julie M. a division of the Foundation of the American College of Healthcare Executives – Chapter on Simulation with Arena and released with Arena demo CD Copyright © 2009 Rockwell – Publisher is Health Administration Press. Hays – Purchase – Amazon.New Textbook • Healthcare Operations: Quantitative Methods for Quality and Performance Improvement. 11 . – Authored by Daniel B. Inc. All rights reserved.

12 . All rights reserved.Arena resources and reference materials are available around the world. Copyright © 2009 Rockwell Automation. Inc.

What is Simulation? Discrete Event Simulation Models events that occur over time. Inc. All rights reserved. What can Simulation do for you? Simulation allows users to draw inferences about: • a new system’s behavior without building it. Copyright © 2009 Rockwell Automation. • an existing system’s behavior without disturbing it. and all variability associated with these events What is a Simulation Model? A mathematical model of a real or proposed system for the purpose of evaluating the system’s behavior under variable conditions. 13 .

can our current capacity support an increase?” • Answer these and other “What if…?” questions before investing capital and without disrupting current hospital operations. 14 .When Should We Use Simulation? • Test major changes to patient flow processes. – “If my patient mix changes. All rights reserved. how will it affect my system throughput?” – “Why are all these patients waiting in the hallways?” – “Do we need more staff? More beds? More ED’s?” – “How would bedside registration work for us?” – “Will Team Triage reduce ED waiting times?” – “What if the number of patients doubles. Inc. Copyright © 2009 Rockwell Automation.

15 .Why Simulate a Process? • Low risk. All rights reserved. Inc. DMADV • • • • • Improve services & lower costs Avoid wasteful spending Visualize problems and solutions Communicate ideas Build consensus Copyright © 2009 Rockwell Automation. high return • Get it right the first time when changing or designing complex processes! • Lean and Six Sigma initiatives – Value Stream Mapping • identify & eliminate NVA activities – Analyze the impact of variability • DMAIC. DFSS.

single queue process: Scenario #1: constant patient arrival rate. constant exam time Scenario #2: variable patient arrival rate. variable exam time What impact does variability have on this simple process? Copyright © 2009 Rockwell Automation. constant exam time Scenario #3: variable patient arrival rate.Variability: The Source of All Problems! Observe 3 scenarios of a simple. All rights reserved. 16 . Inc. single server .

Inc. 17 . All rights reserved.Advantages of Simulation • • • • • • • Variability System Interactions Time Animation Bottlenecks Complexity System Discovery Excel Simulation Copyright © 2009 Rockwell Automation.

Inc. 18 .Queuing and Simulation • A queue is simply a line that entities (people. All rights reserved. widgets…) wait in • Queuing calculations are the only way to truly estimate waiting times in systems • Calculations by hand and using spreadsheets can be complex and time consuming • Inherent in simulation software Copyright © 2009 Rockwell Automation.

mode.3.3.spreadsheet analysis is not sufficient Copyright © 2009 Rockwell Automation.8) ( +.8) Avg Wait Time (min) 38.2 o Millions may be wasted on excessive capacity! o Run scenarios to determine the optimal capacity Better analysis tools are critical. Inc. we should double our capacity.8 +.Arena and Queuing • Single server system: How much capacity should our new facility hold if the patient arrivals double? • “If the patient demand doubles. 19 .” • WRONG! System Current Proposed Arrival Rate (patients/day) 48 96 Capacity (Beds) 10 20 LOS (hrs) (min. All rights reserved.5.9.max) (1.8 15.

20 .Arena Product Family • Arena Basic Edition ─ Entry level. Not suitable for modeling material handling or complex business processes. Inc. Greenbelt simulation tool. All rights reserved. BE is a subset of all high end Arena products. Models most business processes at a high level of detail. – Basic Process Copyright © 2009 Rockwell Automation.

21 . or custom pictures. – Basic Process – Advanced Transfer Copyright © 2009 Rockwell Automation. All rights reserved. maps. or AGV's. and/or material handling devices such as conveyors. objects. transporters. Inc.Arena Product Family • Arena Basic Plus ─ Enhance your Basic Edition models by animating the movement of people. Animate entity travel on imported AutoCAD drawings.

Inc. All rights reserved. – Basic Process – Advanced Transfer – Advanced Process Copyright © 2009 Rockwell Automation. control over entity movement. user-defined expressions. and interfacing with external data.Arena Product Family • Arena Standard Edition ─ Advanced modeling power for handling complex processes with intricate design logic. 22 . custom statistics.

Arena Product Family • Arena Professional Edition ─ The flagship Arena product. – – – – – – – Basic Process Advanced Process Advanced Transfer Flow Process OptQuest Template developer tools SIMAN Copyright © 2009 Rockwell Automation. Inc. All rights reserved. in all domains. 23 . A Blackbelt simulation tool that models nearly all business processes. at any level of complexity.

24 .Arena Product Family • 3D Player – For unmatched visual impact. When animation is critical to successfully presenting a model Copyright © 2009 Rockwell Automation. All rights reserved. Inc.

2. All rights reserved.Arena Demonstration 1. 6. 4. Define basic process logic Define resources & entities & their costs Basic Animation Run model & view reports Define advanced process logic Advanced Animation Copyright © 2009 Rockwell Automation. Inc. 3. 5. 25 .

All rights reserved. 26 . Inc.Arena Products & Services • Arena software (ask your local sales representative for pricing): – – – – Basic Edition Basic Edition Plus Standard Edition Professional Edition • Training: – Scheduled 4-day class at a Rockwell facility – Onsite 3-day class • Project assistance for new users – project “jumpstart” service – model building help @ daily rates – turnkey simulation project services • Arena Success Package for new users: – Discounted: • Software • Support • Training • Project jumpstart service Copyright © 2009 Rockwell Automation.

cjjurishica@ra.Contact me to discuss your specific modeling application. . Insert Photo Here Questions? Copyright © 2009 Rockwell Automation. Inc. All rights reserved.