Using Simulation in Various Stages of Hospital Planning

The public healthcare sector faces great challenges due to increasing cost. There is huge challenge to increase productivity while at the same time the population is getting older and the need for health care services is on the rise. When designing new hospitals and renovating existing buildings and processes, it is very important, that planners and decision makers take into account these challenges. There are advanced methods and software for designing and modelling buildings, for example the lighting and energy consumption of the building can be modelled in a very detailed level. However, in health care merely 5-10% of the life cycle cost comes from the building and its features. Instead, 70-80% of the costs are personnel costs and other costs related to the building use.  

Delfoi addresses this problem through Lean thinking and the use of simulation in various stages of hospital planning and use. In this paper, Delfoi demonstrates how process planning and simulation has been used in hospital planning to improve the cost effectiveness of the new hospital. In addition to the costs saving opportunities, this paper also demonstrates, that with the help of detailed process planning and simulation, the functioning of the process from patient perspective can be improved. Improvements in the process can lead to shorter sick leaves and better availability of care. Also in this paper, it is demonstrated, how simulation and process design helps architects and other design disciplines in the timely execution of a hospital planning project.

When designing new hospitals an important aspect is not to bring the old way of operating as it is to the new building. New hospitals should not be seen as just buildings but as functional entities incorporating healthcare processes, resources and patients. The buildings should allow functional changes and improvements during life span.  When the functional changes are ambitious and substantial the effects can be hard to estimate through static calculations or other present means of operations. Simulation is dynamic tool that allows to test different scenarios in volume and ways of working before large, and sometimes out of scale, investments have been made.

This paper illustrates the cost-saving potential of simulation through a case where discrete-event simulation (process simulation) has been used to support the hospital planning and design along the design process of Järvenpää’s social services and health care center. Twelve units from different areas of health care and social welfare will move to the same building in year 2016. The building is designed based on future, year 2030 customer volumes.

In this case simulation was first used in the project to determine the connections between units and their locations inside the building. For example, the laboratory was placed to the ground floor because it has the largest number of customers. In the next phase of the project, the right number of rooms inside the units was determined based on simulation results. For the ward, an even more detailed simulation was used to determine where certain rooms should be situated to minimize unnecessary movement inside the ward and to compare different layout alternatives, that the project architect had designed. Simulation was also used to determine the right number of elevators for customers and materials, and the need for parking space was also simulated.

The use of process simulation and Lean thinking to support the architects’ work will enable the building to be efficient in three ways. Firstly, the work inside the building is done efficiently while unnecessary movement is minimised and working phases that do not add value are removed, both in the patient care as well as in the logistic processes. Secondly, the built space is in efficient use, since unnecessary rooms are removed already in the design phase. Thirdly, the level of service customers perceive is higher due to functioning process. All in all, process simulation helps to cut down and prevent costs along the life cycle of the building.