University of Twente Student Theses


Assessment of an innovative outpatient ward: the Lounge

Zwieten, W. van (2016) Assessment of an innovative outpatient ward: the Lounge.

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Abstract:Background As a result of the merger between Sint Lucas Andreas Ziekenhuis and Onze Lieve Vrouwe Gasthuis, respectively OLVG West and OLVG East, a new strategy in both hospitals will be applied. Low-complexity high-volume surgeries will be allocated to OLVG West and high-complexity low-volume surgeries will be allocated to OLVG East. To adopt to this new setting, OLVG West aspires to create a modern and efficient outpatient ward; the Lounge. As the Lounge has yet to be built, question rise how it can be optimally configured and whether it will improve performance. Therefore the research objective of this thesis is: To determine the required capacity of the Lounge and develop and assess interventions to optimize the performance of care trajectories suitable for the Lounge. Approach First, we analyze the current performance of the outpatient ward before introducing a solution approach to achieve the objective. Specific Lounge performance indicators are added to performance indicators of the outpatient ward, currently used by OLVG West. The reason for this is to compare future and current situation in order to create a realistic reflection of the performance of the Lounge. Patients and procedures suitable for the Lounge are selected in consultation with specialists. To achieve the objective, a discrete event simulation (DES) model is built. In DES the system is represented as a chronologically-linked sequence of events, in order to describe flows of patients and explore the effects of changes. These features are necessary for further experiments and to create more insight for stakeholders about the way the Lounge will operate. Advice is collected from various specialists, nurses, managers and other employees, in order to create a realistic model of the Lounge. Historical data of 2014 are used to determine distributions of several input parameters of the model. Two stages of experiments and a total of 136 experiments have been performed in which experimental factors and circumstances are altered. The experimental factors are closing time, slack on registration, slack on preparation, number of Lounge spots, dedicated spots, and OR scheduling sequence. The first stage of the experiments aims on altering only one experimental factor, which will be compared with the ‘starting point’ experiment to register the effect. A combination of experimental factors will be altered in the second stage of the experiments to determine the combined optimal setting (COS). After that, experiments are conducted in order to identify the Lounge performance under different circumstances.
Item Type:Essay (Master)
OLVG West, Amsterdam, Netherlands
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:31 mathematics, 44 medicine
Programme:Industrial Engineering and Management MSc (60029)
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