Using discrete event simulation to design a more efficient hospital pharmacy for outpatients

Reynolds, Matthew; Vasilakis, Christos; McLeod, Monsey; Barber, Nicholas; Mounsey, A; Newton, Sharon; Jacklin, Ann; Franklin, Bryony Dean

doi:10.1007/s10729-011-9151-1

Cited by 52 publications

(35 citation statements)

References 15 publications

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“…The results of a study in a hospital inpatient pharmacy in Malaysia (47) showed a sharp decrease in patients’ waiting time by adding an extra person for receiving prescriptions at the beginning of the service delivery process, which is consistent with the results of current study. In another study, the results showed that there was a significant decrease in the consultation time and total patients’ waiting time if one physician only provided medico-surgical care and another physician provided only dermatological care (24). On the other hand, results of a study (48) showed that prescription filling interruptions and delays can be reduced by employing and hiring appropriate number of employees in the peak periods of referring to the pharmacy.…”

Section: Discussionmentioning

confidence: 99%

“…The results of some studies indicate a strong correlation between total customer satisfaction and their satisfaction from drug services (21-23). The main variables determining the waiting times for an outpatient pharmacy include: 1: The model of receiving prescriptions; 2: The sequence of work; 3: The percentage of staff working (on duty); and 4: job interactions among providers working in the pharmacy (24). The Queuing theory is an analytical survey of waiting in queues as a comprehensive and scientific background in the operation management (25).…”

Section: Introductionmentioning

confidence: 99%

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Using Queuing Theory and Simulation Model to Optimize Hospital Pharmacy Performance

Bahadori¹,

Mohammadnejhad²,

Ravangard³

et al. 2014

Iran Red Crescent Med J

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Background:Hospital pharmacy is responsible for controlling and monitoring the medication use process and ensures the timely access to safe, effective and economical use of drugs and medicines for patients and hospital staff.Objectives:This study aimed to optimize the management of studied outpatient pharmacy by developing suitable queuing theory and simulation technique.Patients and Methods:A descriptive-analytical study conducted in a military hospital in Iran, Tehran in 2013. A sample of 220 patients referred to the outpatient pharmacy of the hospital in two shifts, morning and evening, was selected to collect the necessary data to determine the arrival rate, service rate, and other data needed to calculate the patients flow and queuing network performance variables. After the initial analysis of collected data using the software SPSS 18, the pharmacy queuing network performance indicators were calculated for both shifts. Then, based on collected data and to provide appropriate solutions, the queuing system of current situation for both shifts was modeled and simulated using the software ARENA 12 and 4 scenarios were explored.Results:Results showed that the queue characteristics of the studied pharmacy during the situation analysis were very undesirable in both morning and evening shifts. The average numbers of patients in the pharmacy were 19.21 and 14.66 in the morning and evening, respectively. The average times spent in the system by clients were 39 minutes in the morning and 35 minutes in the evening. The system utilization in the morning and evening were, respectively, 25% and 21%. The simulation results showed that reducing the staff in the morning from 2 to 1 in the receiving prescriptions stage didn't change the queue performance indicators. Increasing one staff in filling prescription drugs could cause a decrease of 10 persons in the average queue length and 18 minutes and 14 seconds in the average waiting time. On the other hand, simulation results showed that in the evening, decreasing the staff from 2 to 1 in the delivery of prescription drugs, changed the queue performance indicators very little. Increasing a staff to fill prescription drugs could cause a decrease of 5 persons in the average queue length and 8 minutes and 44 seconds in the average waiting time.Conclusions:The patients' waiting times and the number of patients waiting to receive services in both shifts could be reduced by using multitasking persons and reallocating them to the time-consuming stage of filling prescriptions, using queuing theory and simulation techniques.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Using Queuing Theory and Simulation Model to Optimize Hospital Pharmacy Performance

Bahadori¹,

Mohammadnejhad²,

Ravangard³

et al. 2014

Iran Red Crescent Med J

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“…The discrete event simulation deployed in the example can also be used to address other process-driven problems that are subject to substantial variability and to capacity constraints, and where there is a clear need to prospectively ask “what-if?” and explore the likely impact of any changes. For example, similar techniques have been used to address accident and emergency departments,43 44 45 hospital pharmacies,46 intensive care units47 and diabetic retinopathy screening services 48…”

Section: Discussionmentioning

confidence: 99%

Systems modelling and simulation in health service design, delivery and decision making

et al. 2015

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The ever increasing pressures to ensure the most efficient and effective use of limited health service resources will, over time, encourage policy makers to turn to system modelling solutions. Such techniques have been available for decades, but despite ample research which demonstrates potential, their application in health services to date is limited. This article surveys the breadth of approaches available to support delivery and design across many areas and levels of healthcare planning. A case study in emergency stroke care is presented as an exemplar of an impactful application of health system modelling. This is followed by a discussion of the key issues surrounding the application of these methods in health, what barriers need to be overcome to ensure more effective implementation, as well as likely developments in the future.

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“…In Reynolds et al (2011), the authors presented the findings of a discrete event simulation study of the hospital pharmacy outpatient dispensing systems in two London hospitals. They tested scenarios to estimate the likely impact of changes in prescription workload, staffing levels and skill mix, and utilization of the dispensaries automatic dispensing robots.…”

Section: General Applicationsmentioning

confidence: 99%

Computer Simulation Model for Outpatient Clinics in a Brazilian Large Public Hospital Specialized in Cardiology

Chang

Lima

Fernandes

et al. 2019

BJO&PM

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Goal: the main objective of this study is to analyze the behavior of the outpatient department of a large public hospital specialized in cardiology, understanding how the components of this system are related, in order to improve the hospital's performance. Design / Methodology / Approach: a case study was carried out in a public hospital specializing in cardiology with the aid of Modeling and Simulation of System Dynamics. Results: the result showed that variables such as doctor availability and average consultation time have great influence on the service capacity. Limitations of the investigation: the proceedings and times related to the medical staff are particular to each team and they are not standardized. However, in the system dynamics modeling these particularities cannot be included. Practical implications: for theory, there is the state-of-the-art development in terms of how to manage and regarding the methodologies should be applied in a complex referential model composed of several moderating variables, in order to obtain the best use of the available resources (human and material) of the hospital. For practice, the flow of patients in the hospital should be predicted and optimized, adding value to the services provided to its users. Originality / Value: the originality of the work is based on the unprecedented application of quantitative methods for solving problems in Brazilian hospitals.

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Using discrete event simulation to design a more efficient hospital pharmacy for outpatients

Cited by 52 publications

References 15 publications

Using Queuing Theory and Simulation Model to Optimize Hospital Pharmacy Performance

Using Queuing Theory and Simulation Model to Optimize Hospital Pharmacy Performance

Systems modelling and simulation in health service design, delivery and decision making

Computer Simulation Model for Outpatient Clinics in a Brazilian Large Public Hospital Specialized in Cardiology

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