The Use of Arena Simulation Software in Staffing Decisions at Blank Children's Psychiatry Clinic

Rationale / Objectives

As the Blank Children's Psychiatry Clinic increased its patient load, the staff struggled to complete necessary administrative tasks. Reducing time spent on administrative work was required in order to increase the time available for live phone calls and real-time patient interaction. The clinic also had to meet increased insurance-provider requirements and changing staff roles while maintaining high patient satisfaction. To find the most efficient operations for its clinic, the organization stimulated and tested different environments using Rockwell Automation software. 

Project/Program Description & Major Achievements

The Blank Children's Psychiatry Clinic simulated four staffing and floor plan models to determine the best approach for the clinic. Additionally, the clinic implemented modified administrative processes and floor-plan layout based on the simulation software findings. There were four simulated plans tested for changes in the operation and efficiency of the clinic. The first simulated approach was not to change the environment at all in order to observe how the processes and procedures were originally carried out. The second simulation was to change how the processes were managed but to leave staffing as it was. This model was designed to eliminate miscellaneous work and redundant tasks. The third option was to add another physician, with the simulation used to determine the schedule that the physician would use. The model also analyzed the strain on other staff without the addition of another administrative staff member. The fourth option was to add one physician, a part-time administrative staff member, and a part-time nurse. The part-time staff members’ schedules were determined in the simulation to even-out utilization of staffing resources. The fourth model was implemented which added improved work-flow processes and eliminated unnecessary time spent on repetitive administrative tasks resulting in a cost-savings of $42,000.

Lessons Learned

The simulation tool allowed the clinic to test different environments before making any permanent physical changes.  

Further Description

Blank Children's Hospital is a 108-bed environment that embraces and encourages families to be a part of their child's healing and recovery. The Blank Children's Psychiatry Clinic is located in Iowa Lutheran Hospital in Des Moines, Iowa. These organizations are part of the UnityPoint Health system in Iowa which has over 30,000 employees. The Blank Children's Psychiatry Clinic serves children and youth who suffer from anxiety, Attention Deficit Hyperactivity Disorder (ADHD), autism, and other mental health conditions. In order to test the four strategies to be potentially used by the clinic, seven processes to test with the simulations were determined. The first was the administrative duties the clinic must partake in to begin the day. The second was the process that needs to be completed when a patient requests a refill or a referral is requested. The third includes chart preparation which begins 10 days before a scheduled visit to verify insurance. Additionally, the procedure for both new and established patient visits were used to assess the simulation. The software program used to establish charges for services given to patients was used to assess the options. Lastly, the processing of the work and documentation of declined insurance claims was utilized. Through the assessment of the clinic's processes and workflows within the stimulated environment, the team was able to assess improvement opportunities without the trial and error of the actual work environment. Each individual model was tested over ten times with each replication spanning a five-day week. The software produced output reports with patient wait times, patient time in the system, scheduled utilization of resources and other key indicators.   

Major Achievements

The simulation data found that model #4, which added an additional physician and two additional part-time staff was determined to be the most efficient system. This model would maintain or reduce wait times, balance current staff schedules, and earn the clinic an annual $42,000 in cost savings. It added improved work-flow processes and eliminated unnecessary time spent on repetitive administrative tasks.

Estimated Additional Staffing Needs Before and After Process Improvement Work and Analysis

Job Role Estimated Need Before Work Estimated Need After Work Dollar Savings
Nurses 1.0 Full-Time Equivalent 0.4 Full-Time Equivalent $30,000.00
Administrative Staff 1.0 Full-Time Equivalent 0.6 Full-Time Equivalent $12,000.00