Simulation in Healthcare Architecture Series #3

What is the architect’s role in simulation?

My two most recent blogs in this series explored the benefits of simulation and three critical components of simulation modeling. This post makes the connection between simulation and healthcare architecture.

Recall that simulation can address process changes, space configurations and staffing levels in healthcare facilities. When resources become overloaded due to growth in physician practices or service lines, these problems may surface as a desire for more useable space. An architect that utilizes simulation modeling at the beginning of the design process brings a powerful tool to the table before a floor plan is conceived.

We redefined the traditional architectural phases to include rigorous analysis of the health system, its resources and the patients who utilize it. Our design phases include Discovery, Analysis, Creation and Solution.

During Discovery, the owner and our design team gains considerable understanding of how their health system operates. We use visioning sessions to determine the strategic goals, mission and values of the healthcare system. At this time we also define the fence posts for our engagement. By limiting the scope, we can develop a more focused solution based on specific metrics that inform a targeted outcome. Traditional elements of this phase, such as volume analysis, bubble diagrams and code reviews, happen in parallel to the visioning components of Discovery.

Once leadership sets high-level goals for the project, we begin Analysis with the front-line staff. At this time, a current state mapping activity helps uncover inconsistencies between how staff think the work “flows” and how it actually flows. While mapping the current state, staff from the same department may describe different methods for completing the same work. The inevitable debate provides a focus area for improvement. After forming a clear picture of how patients and resources move through the current state, the mapping team can discuss desired operating procedures.

Using a future state mapping activity, a facilitator helps the team explore and prioritize potential changes. The healthcare systems engineer analyzes the suggested modifications using a simulation model, determining which elements best achieve the goals of the ideal system. Once finalized, these future state desires are much easier for the architect to translate into spatial requirements, resulting in designs that are more accurate compared with those derived solely from the owner’s verbal requests. The simulation testing performed in the Analysis phase leads to more concise subsequent design phases due to data driven consensus around the workflow and resources needed to achieve that flow. Further code review, adjacency diagrams, mockups and quality control occur concurrently to ensure that the architectural design continues moving forward.

Checkpoints between each of the phases ensure that the project aligns with the vision, schedule and budget set during Discovery. The objectives of Creation encompass a large portion of the architectural documentation. As the architects design the more detailed aspects of the space, including (but not limited to) furniture, utilities and equipment, the healthcare systems engineer tests those spaces for efficiency. Using simulation throughout Creation helps us validate the design against the vision, future state and metrics developed during Discovery and Analysis. Focusing on these elements throughout each phase provides the framework for a concise design process with a clear target outcome.

This overview demonstrates how Array integrates the work of the healthcare systems engineer into the design process. Our simulation models remain a valuable resource throughout the life cycle of the project, functioning as a platform for high level investigations during Discovery and deep dives in the subsequent phases.

Do you have any suggestions about incorporating healthcare systems engineering into the design process?