Study to assess the utility of discrete event simulation software in projection & optimization of resources in the out-patient department at an apex cancer institute in India.

Background And Aims: A study was done to create and run a discrete event simulation in the outpatient department (OPD) of a tertiary care cancer hospital in North India to project and optimize resource deployment.

Methods: The OPD process & workflow as per the expected load at tertiary care cancer hospital were finalized with various stakeholders in a focused group discussion. The finalized OPD process & workflow along with the OPD Building plans were utilized to develop a discrete event simulation model for the OPD at a tertiary care cancer hospital using a discrete event simulator. The simulation model thus developed was tested with incremental patient loads in 5 different scenarios/"What if" situations (Scenario 1-5). The data regarding initial patient load and resources deployed was taken from on-ground observations at the tertiary care cancer hospital.

Results: It was found that rooms and doctors were over-utilized and support staff utilization remained low. This was implemented with a lesser waiting time for patients. No additional support staff was provided thus improving utilization of existing staff and saving on resources. The simulations enabled us to deploy resources just when it was required, which ensured optimal utilization and better efficiency. The peak census helped us to determine the capacity of the waiting area in different scenarios with incremental patient load and resource deployment.

Conclusion: The simulation software was very helpful, as "what if scenarios" could be created and the system tested, without disturbing the normal functioning of OPD. This enabled decision-making before making on-ground changes which saved a lot of time and money. Also, the processes of the old system were reengineered to fit the needs of changing times.