Using Discrete Event Simulation (DES) To Support Performance-Driven Healthcare Design

Aim: This article aims to provide a description of fundamental elements of discrete event simulation (DES), the process and the values of applying DES in assisting healthcare design and planning decision-making. More importantly, it explores how new technology such as electronic medical records, real-time location services (RTLS), and other simulation methods such as space syntax analysis (SSA) can facilitate and complement DES. Background: Healthcare administrators increasingly recognize DES as an effective tool for allocating resources and process improvement. However, limited studies have described specifically how DES can facilitate healthcare design. Method: Three case studies were provided to illustrate the value of DES in supporting healthcare design. The first case study used DES to validate a surgical suite design for shorter surgeon walking distance. The second case study used DES to facilitate capacity planning in a clinic through testing the utilization of exam rooms upon various growth scenario. The detailed process data for the current clinic were captured through RTLS tracking. The third case study applied DES in an emergency department for both site selection in master planning and capacity test at various growth scenarios with seasonal volume swing. In addition, SSA was conducted to evaluate the impacts of design on visual surveillance, team communication, and co-awareness. Conclusions: It is recognized that the DES analysis is an effective tool to address the process aspects of healthcare environments and should be combined with post-occupancy evaluation and SSA to address behavioral aspects of operations to provide more solid evidence for future design.