Using Simulation to Provide Insights into the Concept Development of Patient-Centered Care Services

The United States’ Institute of Medicine established patient-centered care as an aim for the 21st-century health care system. Patient-centered care focuses on the patient, their family members and staff experience, while ensuring patient safety and high clinical quality. A medical center in the Veterans Affairs healthcare system approached the Veterans Affairs Center for Applied Systems Engineering to assist in the redesign of the facility that provides medical cancer care. Their goals were to design a patient-centered, state-of-the-art center. Discrete event simulation provided rough order of magnitude estimates for facility and resource planning. Primary metrics of concern were patient length of stay, patient wait time, and room and staff utilization. The simulation included an animated visualization of ‘a day in the life’ of a patient. It also collected metrics on patient experience and center efficiency. Watching the patient flow animation provided two primary insights to the stakeholders. First, it was evident that the patient care process was patient-centered in that it limited patient movement. Second, observations of traffic flow indicated that the design can accommodate the desired patient demand. The visualization showed that increasing the number of providers resulted in reductions in patient wait times and that reducing the number of exam rooms did not significantly affect patient wait time. This exercise demonstrated the value of simulation in the planning and analysis of facility configurations when considering patient-centered design.