Simulating an interventional platform concept at SSM Health Saint Louis University Hospital

How was Simul8 used?

Evaluating an interventional platform's resource requirements with simulation

To verify the space and bed requirements of an interventional platform at Saint Louis University Hospital's new facilities, the team turned to Simul8 healthcare simulation software to simulate and test the complex patient flows and service processes involved.

Simul8 provided the flexibility needed to quickly make any changes to the individual components within interventional platform model, with each having a dedicated sub-window within the overall simulation.

Beds were modeled within the simulation as a resource and different bed types were allocated at relevant stages of the patient’s progress. Bed resource types included:

• Post-anesthesia care unit (PACU) - typically an open bay area
• Phase two – for patients requiring a lower level of observation and set up within individual rooms
• Phase three – a recliner area for patients with minimal anesthetics
• Short-stay beds – comprising of a 23-hour observational unit

In the patient arrival area of the simulation, patients were randomly allocated based on the probabilities of being an outpatient, inpatient or same day patient using Simul8’s distribution functionality.

The patients would then follow a certain route, based on flow of the different types of patient procedures that will be managed within the interventional model.

Variability was also added to procedure times, scheduling of patient arrival times, distribution of patients and the length of stay in different locations within pre and post areas, to better reflect real life conditions.

SSM Health Saint Louis University Hospital interventional simulation

Getting results with Simul8

Building stakeholder confidence for new healthcare concepts with simulation

The initial results from the simulation revealed the need for 40 phase two areas, 11 PACU, 14 phase three areas and 16 short-stays. Some results surprised the team compared to initial estimates, particularly the PACU numbers, estimated at 20, as well as the number of short-stay beds, estimated at 10.

"This number of short-stay beds was interesting because I really do think it was reflecting some forward-thinking by everybody involved about how care will be provided in the future. This was a bigger number than we had anticipated, but I think it really reflects a shift in care that is an appropriate assumption about how to work in the future." - Frank Zilm, Chester Dean Director, Institute for Health and Wellness Design

From the initial simulation results, a sensitivity analysis was undertaken using healthcare simulation software to test a range of 'what if' scenarios. All of these findings were reviewed again with each service component and any minor adjustments were made.

The optimized simulation and results were presented to the leadership team within the three month period and accepted with little hesitation, as Frank explains:

"The key thing is people understood how we attacked the problem, how we approached it, how we analyzed it, what the simulation models were saying, and then what adjustments we were making." - Frank Zilm, Chester Dean Director, Institute for Health and Wellness Design

Simul8 provided SSM Health with a flexible, risk free environment in which physicians and staff could provide input and recommendations throughout the process to achieve a solution that would work for each component of the complex.

Through the discussions facilitated by using simulation as part of the project, as well as the results and evidence provided, SSM Health's leadership team have been able to build confidence around decision making for the interventional platform ahead of the new facility completion in 2020.