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Using patient flow simulation to improve access at a multidisciplinary sleep centre.

Sachin R Pendharkar^1,2, Diane P Bischak³, Paul Rogers⁴

¹Department of Medicine, University of Calgary, Calgary, AB, Canada.

Journal of Sleep Research

|November 29, 2014

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Long wait times for sleep disorder diagnosis and treatment are common. This study used patient flow simulation to find system bottlenecks, revealing that capacity expansion alone may not improve patient access to care.

Area of Science:

Healthcare Systems Engineering
Sleep Medicine
Operations Research

Background:

Timely access to diagnosis and treatment for sleep disorders remains a significant challenge.
Existing research often overlooks the systemic constraints contributing to prolonged waiting times.

Purpose of the Study:

To identify system constraints causing long waiting times at a multidisciplinary sleep centre.
To utilize patient flow simulation modeling to evaluate potential solutions for improving patient access.

Main Methods:

Discrete-event simulation models were developed using historical data from 150 patients.
The models examined reasons for access delays and tested alternative system configurations.
Four potential solutions, including capacity additions and elimination of triage prioritization, were modeled.

Keywords:

ambulatory care computer simulation health services accessibility sleep disorders waiting lists

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Main Results:

Adding physician capacity improved initial appointment times but delayed polysomnography completion.
Increased respiratory therapist capacity did not enhance model performance.
Eliminating triage prioritization negatively impacted urgent patient wait times without overall improvement.

Conclusions:

Discrete-event simulation effectively identifies healthcare system constraints and allows pre-implementation testing of solutions.
The study's model predicted that proposed capacity expansions would not reduce the time to clinically meaningful patient outcomes.