Reducing access times for an endoscopy department by an iterative combination of computer simulation and Linear Programming

de Wit, J.; Struben, V.M.D.; Overbeek, B.J.H.; Fockens, P.; Elkhuizen, S.G. General rights It is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulations If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: https://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. Abstract To reduce the access times of an endoscopy department, we developed an iterative combination of Discrete Event simulation and Integer Linear Programming. We developed the method in the Endoscopy Department of the Academic Medical Center in Amsterdam and compared different scenarios to reduce the access times for the department. The results show that by a more effective allocation of the current capacity, all procedure types will meet their corresponding performance targets in contrast to the current situation. This improvement can be accomplished without requiring additional equipment and staff. Currently, our recommendations are implemented

Reduce fluctuations in capacity to improve the accessibility of radiotherapy treatment cost-effectively

This paper is motivated by a case study to reduce the throughput times for radiotherapy treatment. The goal is to find a cost-effective way to meet future throughput targets. A combination of queuing theory and computer simulation was used. First, computer simulation to detect the bottleneck(s) in a multi-step radiotherapy process. Despite, the investment in an additional linear accelerator, the main bottleneck turned out to be the outpatient department (OPD). Next, based on queuing theory, waiting times were improved by reducing the fluctuations in the OPD capacity. Computer simulation was used again to quantify the effect on the total throughput time of a radiotherapy patient. The results showed a reduction in both access times as well as waiting times prior to the consecutive steps: the preparation phase and actual treatment. The paper concludes with practical suggestions on how to reduce the fluctuations in capacity, and seems of interest for other radiotherapy departments or other multi-step situations in a hospital

How to deal with fluctuations in hospital processes to improve accessibility?

This thesis shows how quantitative decision support, variability reduction of hospital processes, pooling or separating patient groups, and proactive behavior contribute to improved accessibility by more efficient use of resources. This will enable hospitals to face the challenges in the near future, and cope effectively with budget restrictions, increased competition among hospitals, and the consequences of the aging population for both demand and capacity