Each question half-page one referance

#1

One concept in healthcare that I could see myself using a simulation model to explore is that of finding solutions to waiting lines. I currently have to do this in my current role as director of operations (DO) for a telehealth pharmacy. We get many prescription orders every hour that we have to verify and complete in a timely manner. It is the same as servicing a customer, just our customers need their medications in a hospital setting in which we are not. I like the idea of using a simulation model because it can “enhance decision making by capturing situations that are too complicated to model mathematically (like queuing problems)
(Ozcan, 2017, p. 507). As I am essentially tasked with solving a queuing problem, I like the opportunities this may afford me to solve the problem. 

If I were to go about implementing a simple simulation model, I would start by gathering a team of people that could best support me in its implementation. I would gather decision makers and technical people that could best help our simulation carry out and analyze its results. For my particular simulation I would recommend implementing a Monte Carlo simulation to best simulate the waiting cues that occur in our business because my problem of wait times has a random component that would require it to be reflected in our simulation (Ozcan, 2017). The random component in my simulation would be how many orders we receive per hour. I can control the staff and licensure that is on hand, but I cannot control the number of orders we receive from hospitals around the country. I would utilize a Poisson empirical distribution model for the simulation and would provide the past data of orders received per hour for us to use in our analysis. Then I would lean on my technical team to provide the results and converse with my management team to analyze how they affected our business and what potential solutions we might find. 

#2

developing a simulation model to examine emergency room (ER) wait time will improve efficiency. ER provides health services around the clock for different reasons. First step is to create a team of ER employees skilled in daily ER operations.  Discussions outline strong and weak points, set a time expectation for er visits and offer contininous training g too ER employees. For example, non threating events should be completed within 45 minutes. Life threatening events do not have set completion time frame. However, required events must be performed efficiently and without delay. Based on gathered information, ER includes triage nurses staffed to manage patients requiring urgent care. In the event that a patient is experiencing life threatening symptoms, that patient has priority. throughout the ER experience. All other processes will be addressed after patient is stabilized. If patients do not fall in this category, ER triage nurses perform initial processes such as registration, order testing as needed, reasons for ER visit and place patient in que category aligning with diagnoses provided to triage nurse. If patient issues are colds or headaches, triage nurse will defer those patients to tele med to further decrease patient numbers in ER waiting room. ER has a designated contact in lab solely responsible for testing and results. In the event ER visits are after hours, lab commits to a 24-hour turnaround time. Once these matters are handled, the intent is to ensure wait time is no longer than five minutes before patient-provider contact. Once provider diagnoses patient; visit is documented. Patient file is passed to exit nurses to order prescriptions, provide care instructions and advise patient to see their primary care physician for follow up. This new measure requires constant observation to determine process is operating efficiently. As well as, ensuring staff is motivated to offer opinions about current process, modifications, and deletions to drive ER to gain reputation as an excellent facility.