Prospective Computer Simulation Study to Test the Impact of Consolidating Primary Care Out-Patient Services at McDonald Army Community Hospital

摘要

Computer simulation is an effective operational analysis tool gaining popularity in the health care field. Computer simulation is an objective, data driven decision support system that allows mangers to test solutions before implementation. A prospective computer simulation study was conducted at McDonald Army Community Hospital to aid in the possible consolidation of primary care operations. The primary goal of the study was to determine if the proposed floor plans could meet the access demands created by the consolidation of primary care operations and determine what is the most efficient combination of screening rooms, exam rooms and treatments rooms. Four models were developed using the MedModel computer simulation software. The models evaluated two possible floor plans and tested two processes of care that involved screening patients in separate screening rooms or in the exam rooms. A detailed analysis demonstrated that a combination of 5 screening rooms, 18 exam rooms, and 3 treatment rooms are sufficient to meet the demands of consolidated primary care operations and avoids a major construction project estimated near $300k. The analysis also demonstrated that the process of screening in exam rooms created a bottleneck and would require more than 20 exam rooms and additional staffing. The resources required to expand the floor plan beyond 20 exam rooms are financially prohibitive and not necessary. This study determined that the consolidation of primary care operations is possible with minimal changes required to the current floor plan.