Simulation As a Tool to Assess the Vulnerability of the Operation of a Health Care Facility
Publication: Journal of Performance of Constructed Facilities
Volume 21, Issue 4
Abstract
Health care systems are classified as critical infrastructure systems when responding to disaster events. Physical damage to health care facilities or disruption of their operations or supply chains could prevent an effective response and aggravate the outcome of an emergency situation. Even if a hospital or public health facility were not directly affected by the disaster event, these facilities are required to operate efficiently during an emergency in order to manage a surge of capacity. When infrastructure systems are damaged as a result of man-made or natural disaster events, insufficient supply of resources through these systems affects their performance. In this paper, a system dynamics simulation model will be used as a tool to represent the operation of a health care facility, including the interaction between the different service areas (emergency room, intensive care unit, wards, operating room), the flow of patients inside the facility, and the condition of the infrastructure systems that supply resources (i.e., water, power, transportation of medical supplies) to maintain the operation of the facility. The results of this study may assist hospital administrators in their disaster preparedness plans, providing information regarding the level of occupancy and patients waiting to enter the service areas.
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Acknowledgments
This work was supported by the Bilsland Fellowship, which was awarded by the Graduate School at Purdue University. Funding during doctoral work of the first writer was also provided through the National Science Foundation (NSF) CMS-0201364. These sources of support are gratefully acknowledged. The contents of this paper reflect the views of the writers, who are responsible for the facts and accuracy of the data presented herein. The contents do not necessarily reflect the official views or policies of the Graduate School at Purdue University, nor of the National Science Foundation.
References
Barbera, J., and Macintyre, A. (2002). “A medical and health incident management (MaHIM) system: A comprehensive functional system description for mass casualty and health incident management.” Rep. for the Institute for Crisis, Disaster and Risk Management, George Washington Univ., Washington, D.C.
Centers for Disease Control and Prevention (CDC). (2005). “Emergency preparedness and response.” Strategic national stockpile, ⟨http://www.bt.cdc.gov/stockpile/⟩ (Jan. 15, 2006).
Centers for Disease Control and Prevention (CDC). (2002). “Rapid assessment of injuries among survivors of the terrorist attack on the World Trade Center—New York City, September 2001.” Morbidity and Mortality Weekly Rep., 51(1), 1–5.
Covert, M. H. (2001). “Public health system’s capacity to respond to bioterrorism.” Testimony submitted to Congressional committees and federal agencies in 2001, American Hospital Association, Chicago, December 14.
Drenkard, K., Rigotti, G., Hanfling, D., Fahlgren, T. L., and LaFrancois, G. (2002). “Healthcare system disaster preparedness: Part 1.” J. Nurs. Adm., 32(9), 461—469.
Ford, D. N., and Sterman, J. D. (1998). “Expert knowledge elicitation to improve formal and mental models.” Syst. Dyn. Rev., 14(4), 309–340.
Forrester, J. W. (1969). Urban dynamics, Pegasus Communications, Waltham, Mass.
Gilbert, P. H., et al. (2003). “Infrastructure issues for cities—Countering terrorist threat.” J. Infrastruct. Syst., 9(1), 44–54.
Gillespie, D. F., Robards, K. J., and Cho, S. (2004). “Designing safe systems: Using system dynamics to understand complexity.” Nat. Hazards Rev., 5(2), 82–88.
Grigg, N. S. (2003). “Water utility security: Multiple hazards and multiple barriers.” J. Infrastruct. Syst., 9(2), 81–88.
Hirsch, G. B. (2004). “Modeling the consequences of major incidents forhealth care systems.” 22nd Int. Conf. of the System Dynamics Society, System Dynamics Soc., 1–24, ⟨http://www.systemdynamics.org/publications.htm⟩.
Homer, J. (1985). “Worker burnout: A dynamic model with implications for prevention and control.” Syst. Dyn. Rev., 1(1), 42–62.
Institute for Healthcare Improvement (IHI). (2003). “Optimizing patient flow—Moving patients smoothly through acute care settings.” Innovation Series, Cambridge, Mass., 1–11.
Koelling, P., and Schwandt, M. J. (2005). “Health systems: A dynamic system—Benefits from system dynamics.” Proc., 2005 Winter Simulation Conf., M. E. Kuhl, N. M. Steiger, F. B. Amstrong, and J. A. Joins, eds., Institute of Electrical and Electronics Engineers, Piscataway, N.J., 1321–1327.
Lane, D. C., Monefeldt, C., and Rosenhead, J. V. (2000). “Looking in the wrong place for health care improvements: A system dynamics study of an accident and emergency department.” J. Oper. Res. Soc., 51(5), 518–531.
Lattimer, V., et al. (2004). “Reviewing emergency care systems I: Insights from system dynamics modeling.” J. Emerg. Med., 21(6), 685–691.
Lubyansky, A. (2005). “A system dynamics model of health care surge capacity.” 23rd Int. Conf. of the System Dynamics Society, System Dynamics Soc., ⟨http://www.systemdynamics.org/publications.htm⟩.
Manley, W., et al. (2005). “A dynamic model to support surge capacity planning in a rural hospital.” 23rd Int. Conf. of the System Dynamics Society, System Dynamics Soc., ⟨http://www.systemdynamics.org/publications.htm⟩.
McLaughlin, S. B.4 (2001) “Hazard vulnerability analysis.” Health care facilities management, American Society of Healthcare Engineering of the American Medical Association, Chicago, ⟨http://www.aha.org/aha/index.jsp⟩ (March 2003).
Perspectives. (2001). Joint Commission on Accreditation of Health Care Organizations, December 2001.
Richter, P. V. (1997). “Hospital disaster preparedness: Meeting a requirement of preparing for the worst?” American Society for Healthcare Engineering of the American Hospital Association, Chicago, 1–13 ⟨http://www.aha.org/aha/index.jsp⟩ (June 2003).
Schrobsdorff, S. (2005) “Working through the storm: How two New Orleans hospitals—and two ER physician brothers—endured heat, floods and power outages to treat victims of Katrina.” Newsweek, ⟨http://www.msnbc.msn.com/id/9229349/site/newsweek/⟩ (September 8, 2005).
Sterman, J. D. (2000). Business dynamics: Systems thinking and modeling for a complex world, McGraw-Hill, Boston.
U.S. General Accounting Office (GAO). (2003). “Hospital emergency departments: Crowded conditions vary among hospitals and communities.” GAO Rep. GAO-03-460, Washington. D.C. ⟨http://www.gao.gov/⟩ (November 2005).
Ventana Systems. (2005). Vensim PLE, version 5.4d, ⟨http://www.vensim.com/⟩ (April 2005).
Wolstenholme, E. (1999). “A patient flow perspective of U.K. Health Services: Exploring the case for new ‘intermediate care’ initiatives.” Syst. Dyn. Rev., 15(3), 253–271.
Information & Authors
Information
Published In
Journal of Performance of Constructed Facilities
Volume 21 • Issue 4 • August 2007
Pages: 302 - 312
Copyright
© 2007 ASCE.
History
Received: May 12, 2006
Accepted: Jan 9, 2007
Published online: Aug 1, 2007
Published in print: Aug 2007
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