Abdominal surgery process modeling framework for simulation using spreadsheets

Area of Science:

• Healthcare Operations Research
• Simulation Modeling
• Health Systems Engineering

Background:

• Existing Activity Table Modeling (ATM) methodologies require enhancements for practical application in complex healthcare settings.
• Spreadsheet-based simulations offer accessibility but often lack modularity and ease of extension.
• Modeling patient flow in surgical departments is crucial for optimizing resource allocation and patient care.

Purpose of the Study:

• To extend the Activity Table Modeling methodology using a modular spreadsheet simulation approach.
• To develop a user-friendly simulation model for the abdominal surgery cycle process.
• To demonstrate the applicability of the proposed methodology in simulating patient flow within a clinical setting.

Main Methods:

• Developed a modular spreadsheet simulation model with 28 elements for the abdominal surgery cycle.
• Implemented a first-in-first-served approach for servicing multiple patients.
• Modeled uncertain activity durations using the "rand()" function and patient movement with nested "if()" functions.
• Ensured the model is macro-free, requiring no programming experience for use or modification.

Main Results:

• Successfully simulated a two-week patient flow in a 75-bed abdominal clinic, validating the methodology's applicability.
• The modular approach enhanced model readability and facilitated easy upgrading and extension with other activities or models.
• The simulation effectively tracked patient movements through various activities without complex programming.

Conclusions:

• The modular spreadsheet simulation is a viable and accessible extension of the Activity Table Modeling methodology for surgical processes.
• The developed model offers improved readability, extensibility, and ease of use compared to existing methods.
• This approach provides a practical tool for analyzing and optimizing patient flow in abdominal surgery departments.