Related Experiment Video
Updated: Jan 10, 2026
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
Data-Driven Leadership in Internal Medicine Clinics: A DES-DOE Framework for Optimizing Patient Flow and Turnaround
Chawis Boonmee1,2, Wipada Thamtrakul3
1Humanitarian Logistics and Crisis Operations Research Unit, Department of Industrial Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai, Thailand.
Purpose:
Efficient leadership in healthcare requires actionable insights to improve both service quality and patient outcomes. This study aims to enhance outpatient service efficiency by applying a data-driven decision-support framework that integrates Discrete Event Simulation (DES) with Design of Experiments (DOE). The focus is on optimizing patient flow and reducing turnaround time in an internal medicine clinic of a Thai public hospital.
Methods:
A hybrid DES-DOE model was developed to replicate the clinic's real-world processes and assess the impact of key operational factors. The DES model, built in Arena, captured detailed workflows and resource constraints. A full factorial DOE design evaluated five critical variables: patient arrival patterns, physician availability, consultation start-time delays, pre-appointment blood testing, and proportions of patient categories (eg, cardiovascular, neurological, endocrine). A total of 32 scenarios were tested and analyzed using ANOVA.
Results:
All five factors significantly influenced turnaround time, with patient category proportions showing the strongest effect. The optimized scenario resulted in a 10.46% reduction in average turnaround time. These findings suggest that targeted, evidence-based adjustments can substantially improve patient throughput and clinic performance.
Conclusion:
This research provides healthcare leaders with a validated, replicable framework for improving operational efficiency through simulation-based experimentation. It demonstrates how integrating DES and DOE can support strategic planning, workforce management, and service design, ultimately contributing to better patient experiences and more resilient healthcare systems.
Related Concept Videos
01:15Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
01:26Methods of Documentation IV: Focus Charting
It typically involves three columns for recording information:
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
01:17Flow Sheet
Here's a closer look at the examples of flowsheets commonly used by nurses:
Graphic Sheet Documentation:
01:21Methods of Documentation III: PIE
01:30Ethical Dilemmas II