مدیریت اطلاعات سلامت (Sep 2017)
A Study on the Theory of Constraints Application in Improving Patient Flow in Specific Treatment Centres
Abstract
Introduction: Theory of constraints is a managerial view which aims at increasing the system efficiency by identifying constraint processes. Present study aimed to apply the theory of constraint in scheduling system of a healthcare facility in order to increase efficiency and decrease patient wait times. Methods: The present research was a descriptive-analytical study through using cross-sectional method on 130 patients of a cancer treatment center. To simulate the patient flow, a discreet event simulation model was employed. The required data for simulating the patient flow were acquired using a questionnaire from patients and direct observation. After simulating the model in Simul8 software, different scenarios were developed and their effects were tested on patient wait times and system output. Results: The results from the simulation of different scenarios showed that using the third scenario, which was based on the theory of constraints principles, could balance the trade-off between average wait times and average system output. In comparison to output maximization scenario, only by a 4.36 percent decrease in average daily patient output, drum buffer rope (DBR) scenario improved average waiting times by 41.39 percent. On the other hand, relative to minimizing the wait time scenario, DBR scenario increased the average daily patient output by 29.97 percent, while increased the average wait times by 11.66 percent. Conclusion: Findings showed that employing the concepts of theory of constraints in healthcare can be significantly effective in managing the bottlenecks, reducing patient wait times, and improving system efficiency.
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