Using discrete-event simulation to address COVID-19 health and safety guidelines in outpatient laboratory clinic

  • Daniel Zemaitis , 
  • Angela Green , 
  • Alexandra Mukavitz , 
  • Jennifer Dhanapal , 
  • Myriah Kahlmorgan , 
  • Edward J. Williams  
  • a,b,c,d,e,f University of Michigan – Dearborn, 19000 Hubbard Drive, Dearborn, Michigan, 48126, USA
Cite as
Zemaitis D., Green A., Mukavitz A., Dhanapal J., Kahlmorgan M., Williams E.J. (2021). Using discrete-event simulation to address COVID-19 health and safety guidelines in outpatient laboratory clinic. Proceedings of the 10th International Workshop on Innovative Simulation for Healthcare (IWISH 2021), pp. 84-89. DOI: https://doi.org/10.46354/i3m.2021.iwish.013

Abstract

Simulation has, over multiple decades, achieved a remarkable record of improving operational efficiency and effectiveness in many areas – manufacturing, supply chains (including commercial transportation and logistics), health care, public-sector transport, service industries, and military operations.  About ⅔ through the twentieth century, simulation’s earliest successes appeared in the manufacturing sector.  These successes began with attention to value-added operations (e.g., at machines often entailing high capital investments) and rapidly spread to the non-value-added but very necessary material-handling requirements within factories.  SARS-CoV-2, (COVID-19) has caused a rapid, widespread change in patient care across the globe.  New health and safety guidelines have been established by the Centers for Disease Control and Prevention (CDC) (Health Care Guidelines, 2020).  Still, it has been left to individual facilities to address and implement solutions to new standards for social distancing and cleanliness.  Here we develop a discrete-event simulation model to simulate an outpatient laboratory clinic, including check-in and patient interaction, to determine if changes lead to increased efficiency and reduce patient wait times, without increasing staffing or additional resources.  Under the aegis of the University of Michigan Medical Group (UMMG), this simulation is validated against real data of waiting time at the University of Michigan Canton Health Center (UMCHC) during the height of the pandemic.

References

  1. Abu-Taieh, E. and ElSheikh, A. (2009). Commercial simulation packages: A comparative study. International Journal of Simulation Modelling (8,2), 66-76.
  2. Ahmad, Jawad, Iqbal, J., Ahmad, I., Khan, Z. A., Tiwana, M. I., and Khan, K. (2020). A Simulation Based Study for Managing Hospital Resources by Reducing Patient Waiting Time. In Access IEEE(8), 193523-193531.
  3. Benneyan, J. C. (1998). Distribution fitting software makes simulation more attractive, viable in many applications. OR/MS Today (98:38,1-10).
  4. Centeno, M. A. and Díaz, K. A. (2015). Simulating Health Care Systems: A Tutorial. In Proceedings of the 2015 Winter Simulation Conference, eds. L. Yilmaz, W. K. V. Chan, I. Moon, T. M. K. Roeder, C. Macal, and M. D. Rossetti, 1835-1849.
  5. Currie, C. S. M. and Cheng, R. C. H. (2013). A Practical Introduction to Analysis of Simulation Output Data. In Proceedings of the 2013 Winter Simulation Conference, eds. R. Pasupathy, S.-H. Kim, A. Tolk, R. Hill, and M. E. Kuhl, 328-341.
  6. Figueredo, E. J. (2016). Simulation in Health Care. In Revista Colombiana de Anestesiología 44(4), 270-271.
  7. Goos, P. and Meintrup, D. (2015). Statistics with JMP: Graphs, Descriptive Statistics and Probability. West Sussex, UK: John Wiley & Sons, Limited.
  8. Law, A. M. (2019). How to Build Valid and Credible Simulation Models. In Proceedings of the 2019 Winter Simulation Conference, eds. N. Mustafee, K.- H.G. Bae, S. Lazarova-Molnar, M. Rabe, C. Szabo, P. Haas, and Y.-J. Son, 1402-1414.
  9. Martin, J., Singh, P., Kiel-Locey, J., Shehadeh, K., Cohn, A., Saini, S., and Kurlander, J. (2020). Integrated Simulation Tool to Analyze Patient Access to and Flow During Colonoscopy Appointments. In Proceedings of the 2020 Winter Simulation Conference, eds. K.-H. Bae, B. Feng, S. Kim, S. Lazarova-Molnar, Z. Zheng, T. Roeder, and R. Thiesing, 934-943.
  10. Myers, G. J. (1975). Reliable Software Through Composite Design. New York, New York: Van
    Nostrand Reinhold Company.
  11. Nakamura, I., Fujita, H., Tsukamori, A., Kobayashi, T., Sato, A., Fukushima, S., Amano, K., and Abe, Y. (2018). Scenario-based simulation health care education for performance of hand hygiene. In American Journal of Infection Control 47(2), 144-148.
  12. Smith, J., Sturrock, D., and Kelton, W. (2018). Simio and simulation: Modeling, analysis, applications, 5th ed. Sewickley, Pennsylvania: Simio LLC.
  13. Sargent, R. G. (2015). An Introductory Tutorial on Verification and Validation of Simulation Models. In Proceedings of the 2015 Winter Simulation Conference, eds. Levent Yilmaz, Il-Chul Moon, Wai Kin (Victor) Chan, and Theresa Roeder, 1729-1740.