“based on Nurse Workload” patient destination assignment

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Christopher Morgan asked Sep 30, '16 Christopher Morgan commented Oct 10, '16

“based on Nurse Workload” patient destination assignment

Hello all,

I’m currently building a model that will require nurses on the same team (FlexSim staff grouping) to cover individually assigned rooms so that patients will be assigned to the "least busy" nurse’s designated areas based off of the nurse’s current workload. I found the patient destination option “Based on Nurse Workload” in FlexSim HC 5.1 which seems fantastic from the description, but I’m having a hard time understanding how to get it to function properly.

I’ve attached a practice model I’ve made below where I’ve been trying to build this so that “nurse 1” would cover exam tables “2, 4, 6” and “nurse 2” would cover exam tables “1, 3, 5”.

I feel like I need a few things to get this right:

1. A little deeper explanation on how “based on Nurse Workload” works
- I get the feeling the third option over the patient label portion for the “nurse row” may be important here, I just haven’t been able to determine what this is and how it functions.
2. What would be the best way to increment the global table value down as patients are discharged? I’m guessing this would probably utilize the "increment table cell" trigger with some type of additional logic, but i'm not sure what or how that logic would be.
3. I noticed the “based on Nurse Workload” in my current model breaks down at 8:44am model time and Nurse 2 takes over for nurse 1, but instead takes the patient to nurse 2’s area instead of her own. Why?
4. This also breaks down when a nurse is “full” or on break and it seemingly locks patients into a “null” waiting status where they stay skipped over, is there an effective way to fix this so the process will stay as close to "fifo" as possible?
5. If there are any other good tricks to utilizing this tool I’d love to hear them.

Sorry if this is a long post, but I haven’t found much info about this tool after some searching beyond the base explanation and it seems like it could be really useful for several HC applications. Any guidance/info would be greatly appreciated.

Thanks, Chris M

nurse-assign-test.fsm

Software Version:

FlexSim HC 5.1.0

healthcare flexsim hc flexsim hc 5.1 first available destination based on patient location or area

nurse-assign-test.fsm (524.1 KiB)

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Attachments: Up to 12 attachments (including images) can be used with a maximum of 23.8 MiB each and 47.7 MiB total.

Kari Payton commented · Sep 30, 2016 at 01:52 PM

Hi @Christopher Morgan you may get faster/better responses if you separated these questions into different posts.

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Sam Stubbs ♦ commented · Sep 30, 2016 at 03:59 PM

As Kari said, it'll be easier to answer your question if you could possibly break up any of this into multiple question posts.

For future reference, you may want to check out this post that explains how best to use the Answers forum.

https://answers.flexsim.com/articles/22192/best-practices-for-using-this-answers-site.html

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Christopher Morgan Sam Stubbs ♦ commented · Sep 30, 2016 at 09:52 PM

It felt necessary to right the question this way to me since every one of the subpoints is about the concept of the "based on nurse workload" option and how it should effectively work. I actually read through that article before posting because i was concerned about length, but i wanted to make the question as clear as possible instead of just saying explain "x". Sorry for the trouble.

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Answer 1 · 2016-10-05T15:14:39Z

Cliff King answered Oct 5, '16 Christopher Morgan commented Oct 10, '16

I've attached a model that demonstrates use of the "Based on Nurse Workload" pick list option. I've documented the workings of the model in one of the dashboards. Please note that if members of your team go Off Schedule and requests originally intended for them are automatically reassigned to other members of the group, the workload parameters will not automatically be adjusted. This would be a somewhat difficult task to manage on your own using code in the Member Selection Policy. Shift changes are always going to be a difficult thing to accurately model regardless of the circumstances. I usually choose to not go through the extra effort to try and accurately model the many nuances of a shift change that occur in real life, and concentrate instead on the steady state conditions before and after the shift change. equitable-nurse-assignments-based-on-acuity-worklo.fsm (this is an HC 5.1.0 model)

equitable-nurse-assignments-based-on-acuity-worklo.fsm (160.5 KiB)

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Attachments: Up to 12 attachments (including images) can be used with a maximum of 23.8 MiB each and 47.7 MiB total.

Christopher Morgan commented · Oct 10, 2016 at 03:58 PM

This was an excellent example cliff, thank you. With your example, i was able to apply this into my own model and get everything to work exactly how i hoped. Thanks again!

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Answer 2 · 2016-09-30T15:08:17Z

Lou Keller answered Sep 30, '16 Christopher Morgan commented Oct 10, '16

Hi Chris,

I fully understand your frustration, believe me. The Inpatient model is the single most difficult model to design if only because it has three components, a discrete track where activities begin and end with some regularity, another discrete track where activities of both decreasing and consistent frequency occur, and a time-based track meant to do nothing but determine a patient's length of stay. I've attached a model of an inpatient nursing unit that handles all three of these requirements, from nursing rounds, to collection of vitals signs, to change in nursing shifts, to delivery of meal trays, etc. In addition, all nurses are assigned specific beds whose patients they attend to when the bed is occupied. Moreover, you'll also notice that patients are differentiated for bed assignments, not just based on sex, but on whether they're infectious. Needless to say, the model is complex. Because I don't have a complete write-up on what it does and how, I'd like you to take a look at the model and then get together with me during a Go-To-Meeting that I'll set up based on your schedule. When you look at the model, pay particular attention to the Shift schedules (determines nurse availability), Global Processes (determines recurring task performance), Patient Tracks (determines length of stay), Alternate Groups (determines shift membership and nurse availability), etc.. Like I said, inpatient modeling is complex and changeling. But, it's not impossible. inpatient-recurring-task-demo-model.fsm

inpatient-recurring-task-demo-model.fsm (791.4 KiB)

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Attachments: Up to 12 attachments (including images) can be used with a maximum of 23.8 MiB each and 47.7 MiB total.

Christopher Morgan commented · Sep 30, 2016 at 09:56 PM

I definitely wouldn't say frustration, I'd say more curious. I'm really enjoying learning the software so far actually to be honest.

Wow this is a really interesting model! I'll Reach out to you next week when i'm back in office and have had time to review all of it. Thank you for the offer and for sharing!

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Christopher Morgan commented · Oct 10, 2016 at 04:01 PM

This is a great model Lou! I was able to start building in some of things i need in my current model and it answered a lot of other questions i had been wondering about. for some future projects. I know i'll be utilizing this and some of its components going forward. Thank you for your help Lou!

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