How to make different types of patients leave waiting room early

[fenia_tseligka]

[ FlexSim HC 5.0.12 ]

There are 3 types of patients tracks, that will leave the waiting room of the HC unit after some particular time (time differs for each type). More specifically, the patients will be leaving without being seen by a doctor after their waiting tolerance expires. How do i make that happen in Flexsim HC? Thank you in advance.

[adrian_haws]

You can accomplish this through patient activities and PCIs. For each of your patient tracks, simply make a "Process" activity after the patients arrive to the waiting room. You can then manually enter the processing time for each patient track, and omit any staff requirements.

You can then set up different Patient Classification Index (PCI) numbers for the three types of patients, and specify which patient track each will go to. Finally, make sure that the patient arrival pattern is set up for each PCI.

Let us know if anything is unclear.

[regan_blackett · Accepted solution]

Handling this with the Patient Queuing objects built in features for "Patient Condition" would seem to be the best approach for this problem (located below in the object properties)

The Evaluate patient field asks for a time interval where you will check to see if the patient will execute a Leaving without being seen event and the Patient leaves Early field lets you set up conditions that will cause the patient to leave early and what they should do if flagged to leave early. One note on the Evaluate field, this creates an event every 'X' time that you put in so if your interval is very short it creates a lot of 'ticks' in your model that may make stepping through events take a longer than normal.

Here's an example of what the configuration of this field could look like along with a sample model with it in use.

In my model I created two PCI's (that follow the same track, but you could easily set up PCI's that have different tracks and use the same methods) and I want each of the PCI's to have a different time threshold for when they can leave early, such that PCI 1 leaves if they have been in the waiting room for longer than 5 minutes or if they are PCI 2 they leave if they have been in the waiting room for more than 10 minutes.

I write my condition in the Blue text above to first get the PCI of the patient and then check the time they have been in the waiting room by checking the total elapsed time in the model (time()) and subtract the time that they entered this object (getentrytime(patient)). This is actually two conditions separated by the OR operator ( || ) one for when PCI is 1 and the other for when PCI is 2 and could be read to say

"if the PCI label of the patient is 1 AND the patient has been in waiting room for longer than 5 minutes OR if the PCI label of the patient is 2 AND the patient has been in waiting room for longer than 10 minutes"

Another thing I did, just to verify that it is working is I saved the time spent in the waiting room to a Label on the patient called LWBS so that if a patient leaves early you can see how long they were in the waiting room before they decided to leave, and I set that up in the same field as the above picture.

Try sample model and let me know if you have any other questions.

waiting-room-lwbs.fsm

[fenia_tseligka]

Thank you very much for your interest. I did what you proposed but still getting some errors.

[fenia_tseligka]

@regan.blackett thank you very much for your answer. It was really helpful, however, this is my first project in Flexsim and i have some more questions about a malfunction in the simulation.

To be exact, i made all the changes you proposed and was fit to my problem, however when the simulation runs, there seems to be some problem at an exact simulation time (i attached the error log in .txt format). Things are getting even more weird when i attempt to change the "evaluate patients every" field, because the times the error occurs differ depending on the evaluation time. I have no clue about what is wrong with it, nor how to fix this. Thank you in advance.

flexsimhc.txt

[adrian_haws]

@fenia tseligka Did these exceptions only happen after you applied Regan's suggestions? Also, could you please send us your model? That's often very helpful in determining the cause of exceptions.

[fenia_tseligka]

@Adrian Haws Unfortunately, i cannot publicly post my model for the time being, as long as it is part of my diploma thesis and the proffesor's permission is required.

Yes, exceptions happened after @regan.blackett 's proposed changes. Do you have any clue why that happened? Is there anything i can do to avoid those problems?

Furthermore, could you please describe what the "evaluate patients every" field actually does to the program, because when i set this field to 60 minutes for all waiting rooms (i have three of them), no problem occurs for the desired interval (i simulate the processes of 1 week)

[adrian_haws]

@fenia tseligka The "Evaluate Patients Every" field tells how often to see if the patient meets a certain requirement. For example, if you set that field to 60 minutes for a "Patient Leaves Early" event it will check every hour to see whether the conditions you set for that event are true.

I'm not sure why it would be working for that value but not for others. With the exceptions you're getting all I can really guess is that something is wrong in a task you're asking "RN_1" to perform. If you would like, you can ask a private question by checking the box just below the question title to share the model with FlexSim moderators only.

[fenia_tseligka]

@Adrian Haws thank you again for answering in such sort notice. If i leave the field to 60 minutes, will be any mistakes in the results or do you think the hourly check for leaving early is viable based on your experience? thank you in advance.

[adrian_haws]

@fenia tseligka I would say it depends on what you're trying to simulate. For example, maybe you want the patient to leave after between 40 and 50 minutes of waiting. Let's say you have the condition evaluated every 60 minutes. If a patient arrives at 30 minutes, when the condition is evaluated at 60 minutes if wouldn't be true since he's only been there for 30 minutes. He would have to wait until the next check, which would be at 120 minutes. By that time he would've been waiting for 90 minutes, far above the preferred amount of time.

So, it depends on the condition you set and how you want it to work. Maybe the exact time isn't as important as the model running quickly. There's just kind of a give and take between the two.

[adrian_haws]

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