This patient pathway model is designed to simulate a typical acute hospital outpatient, admission, treatment, and followup pathways. It uses Discrete Event Simulation (DES) methodology, and is implemented using the open-source {simmer} R package.
It is designed to be used by hospital management and clinicians to investigate service configuration options. It models a single pathway, and is configurable so that users can experiment with “what if” questions.
It presents results graphically wherever possible (some of this is still in development).
The model uses a blend of hard-coded assumtions, and a set of configurable options. Over time (or by request), options that are currently hard-coded may be made user-configurable.
- Number of weeks to forecast ahead (default is 2 years)
- Patient referral (arrival) rate
- Conversion rate (from OP appointment to admission / treatment waiting list)
- Outpatient appointment followup rate (what proportion of OP appts are new vs. followups)
- Existing service waiting list (backlog size)
- Outpatient clinics:
- Number of clinics (schedule)
- OP clinic appointment length
- Pre-operative ward:
- Number of beds
- Patient average length-of-stay
- Post-operative ward:
- Number of beds
- Patient average length-of-stay
- Operating theatre
- Operating hours (schedule)
- Average procedure length
- Distributions (variation) of length-of-stay, and theatre procedure length
- OP clinics and Operating theatres are currently assumed to be the same every day (ie. 7 day service). The ability to define weekly capacities is planned in due course.
- Appointment non-attendance (DNA - did not attend) is not currently modelled. Attendance is assumed to be 100%
You can install DESPatientPathway like so:
# install.packages("remotes")
remotes::install_github("ThomUK/DESPatientPathway", build_vignettes = TRUE)To run the app on your local machine, use the below:
library("DESPatientPathway")
run_app()or simply:
DESPatientPathway::run_app()