Vincent Augusto

Performance evaluation of an integrated care for geriatric departments using discrete-event simulation

The increasing number of geriatric patients is one of the most important problems for the next years. This kind of patients is often dependent and does not tolerate environment changes so that hospitalization can strongly deteriorate the elderly health state. This paper focuses on two services of the geriatric services: the Short Stay (Acute Care) and Rehabilitative Care (to prepare the return at home). We use Discrete Event Simulation to compare two different configurations (integrated care vs separated) based on two French hospitals case studies. In the integrated configuration both services are located in the same department and in the separated configuration services are independent. We measure the impact of these organizations on the occupancy, admissions, waiting and the total length of stay. We also study the economic impact based on the French funding system taking into account the Diagnosis Related Group of the patient.

Performance evaluation of health information systems using aris modeling and discrete-event simulation

Innovation and health-care funding reforms have contributed to the deployment of Information and Communication Technology (ICT) to improve patient care. Many health-care organizations considered the application of ICT as a crucial key to enhance health-care management. This paper aims at providing a global methodology to assess the organizational impact of high-level Health Information System (HIS) on patient pathway. We propose a performance evaluation for HIS using formal modeling with ARIS (Architecture of Integrated Information Systems) models and a Discrete Event Simulation approach. The methodology is applied to the consultation for cancer treatment process. Simulation scenarios are established to conclude about the impact of HIS on patient pathway. We demonstrated that although high level HIS lengthen the consultation, occupation rates of oncologists are lower and quality of care is higher (through number of available information accessed during the consultation). The methodology is flexible enough to be applied to other health-care systems.

Modelling and simulation of an outpatient surgery unit

In this paper we propose a new approach to design and control an ambulatory surgery unit through formal modelling and discrete-event simulation. Taking into account the demand increase for ambulatory care in the hospital, we propose a comprehensive methodology to adjust the required resources (beds and stretchers) to optimize patient pathway through the ambulatory surgery unit. Several performance indicators are considered such as patient length of stay (late discharge evaluation) and patient waiting time to determine the optimal number of patients and types of surgeries to be performed each day. Resource sizing is also proposed to optimize patient rotation between the ambulatory unit and the operating theater. Along with quantitative results, a risk analysis is also proposed to help decision makers with the implementation of the new organization.

A timed Petri net approach for verification of Territorial Healthcare Information Systems

This paper addresses the performance evaluation and verification of territorial healthcare information systems. For this purpose, we propose a new class of timed Petri nets, called THIS nets (Territorial Healthcare Information Systems), which formally describes patient care-pathways, relevant information flows and their interactions. THIS nets are then used for verification of the health information systems and evaluation of their performances such as cycle time distribution and probability of information availability at some target time. A real example of cancer patient healthcare information system is used to illustrate the usefulness of the proposed approach. We show that advanced information system allows earlier start of the medical consultations and thus a more efficient care pathway.