TY - JOUR
T1 - Exploring trade-offs between staffing levels and turnaround time in a pathology laboratory using discrete event simulation
AU - Pongjetanapong, Kanokporn
AU - Walker, Cameron
AU - O'Sullivan, Michael
AU - Lovell-Smith, Margaret
AU - Furian, Nikolaus
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Many health delivery services have required performance targets. Typically, these targets are presented as percentiles of patients to be seen within specified timeframes. These targets present hospital administrators with a resourcing problem complicated by conflicting objectives: How to minimize costs while maximizing throughput to achieve the performance targets? In this paper, we describe the use of a simulation model to evaluate the effect of changes to staff levels in a cytology department, investigating the trade-off between staff levels and turnaround times in light of performance targets specified by government. Standard practice for determining staffing levels in a cytology department uses average workload estimates and does not take into account target performance measures, task variability, and the interruptive nature of the workload of pathologists. We develop a simulation model for pathologist workload within a cytology department in New Zealand. We describe the model construction process that follows the hierarchical control conceptual modeling (HCCM) framework. We use the resulting simulation model to examine the trade-offs between staffing levels (and associated rosters) and task turnaround time. The results indicate that consideration of variation in task arrivals is important when considering the effect of staffing levels on turnaround time. Furthermore, as the cytology department is required to meet performance targets that involve maximum service times for a percentile of patients, such an approach is necessary in order to estimate the performance level of a staffing roster.
AB - Many health delivery services have required performance targets. Typically, these targets are presented as percentiles of patients to be seen within specified timeframes. These targets present hospital administrators with a resourcing problem complicated by conflicting objectives: How to minimize costs while maximizing throughput to achieve the performance targets? In this paper, we describe the use of a simulation model to evaluate the effect of changes to staff levels in a cytology department, investigating the trade-off between staff levels and turnaround times in light of performance targets specified by government. Standard practice for determining staffing levels in a cytology department uses average workload estimates and does not take into account target performance measures, task variability, and the interruptive nature of the workload of pathologists. We develop a simulation model for pathologist workload within a cytology department in New Zealand. We describe the model construction process that follows the hierarchical control conceptual modeling (HCCM) framework. We use the resulting simulation model to examine the trade-offs between staffing levels (and associated rosters) and task turnaround time. The results indicate that consideration of variation in task arrivals is important when considering the effect of staffing levels on turnaround time. Furthermore, as the cytology department is required to meet performance targets that involve maximum service times for a percentile of patients, such an approach is necessary in order to estimate the performance level of a staffing roster.
KW - discrete event simulation
KW - performance targets
KW - resource planning
KW - staffing levels
KW - trade-offs
UR - http://www.scopus.com/inward/record.url?scp=85061235371&partnerID=8YFLogxK
U2 - 10.1002/hpm.2748
DO - 10.1002/hpm.2748
M3 - Article
C2 - 30734966
AN - SCOPUS:85061235371
SN - 0749-6753
VL - 34
SP - e1119-e1134
JO - International Journal of Health Planning and Management
JF - International Journal of Health Planning and Management
IS - 2
ER -