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Christopher Morgan avatar image
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Christopher Morgan asked Tee Hiett answered

Optional expediting tasks while patient waits for admission

Question:

Is there a way to model performing a small optional task that reduces primary treatment time when completed? This optional task would be performed while a patient waits for their primary treatment location to become available and not cause the patient to lose their place in line with respect to acuity and total wait time.

Example model Background:

I’m trying to build a model where patients are immediately placed in a bed when they arrive if a bed is available and where the primary assigned nurse will conduct a primary assessment before treatment at the assigned bed. If all beds are full, the patient may be taken to an assessment area by a dedicated staff member to perform the primary assessment while the patient waits for the next available bed to expedite the process.

When a bed becomes available, the patient should be admitted with priority based off of acuity, then wait time, and then if a primary assessment has been completed. Ideally the bed would also be held if the highest acuity patient was in the process of receiving the optional task.

My current model uses “first available location” and patient label triggers for identifying completion of Primary Assessments, which causes lower acuity patients who have completed their primary assessment to sometimes receive a bed before higher acuity patients who have not received their assessment yet or are in the process of receiving an assessment. Ideally the higher acuity patient would be admitted first and have the primary RN perform the assessment in the assigned room.

I’ve attached an example of the current demo model. Thanks for reading and any advice given! pa-skip-test.fsm

FlexSim HC 5.1.0
healthcarepatient trackfirst available locationwait for task
pa-skip-test.fsm (131.3 KiB)
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Matthew Gillespie avatar image
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Matthew Gillespie answered Christopher Morgan commented

It looks like your model is mostly already working as you described. The sorting of incoming patients to a location is done in the Entrance Criteria field of the object and is configured by default to sort by acuity, then wait time. If you want to change how patients are sorted you'd have to use the Configurable Entrance Criteria option or write your own custom code.

The biggest issue I saw was that since you were using a decide activity to choose whether or not to go to triage or the bed area, sometimes high acuity patients wouldn't get taken to an open bed because they were waiting to get into triage. I've attached a modified version of your model that uses a Based on Destination Status pickoption in the Patient Destination field to send the patient to either the triage area or bed area, whichever opens up first. The patient does the PA processing time at that location and then the next activity is a decision point that sends triage patients back to the waiting room.

There are occasionally times when a high acuity patient is at the triage area when a bed opens up and someone else takes the bed. That would be a very hard problem to solve though.


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Christopher Morgan avatar image Christopher Morgan commented ·

Thanks Matthew, this is great! I was able to integrate this into my main model just as I hoped.

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Tee Hiett avatar image
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Tee Hiett answered

Nice model demonstrating the use of acuity level

Thanks for sharing,

Tee

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