gms | German Medical Science

Introduction: Process design in healthcare is challenging to perform due to complex processes and little opportunity for flexible modifications [1]. Process optimizations have an impact on costs/resources and employee health/satisfaction. Current process simulation software tools (e.g. FlexSim) in healthcare use methods such as event-driven process chain, BPMNs or UML for process modeling and optimization [2]. However, due to their one- or two-dimensionality, they do not allow any visually realistic representation, ergonomic evaluation or interaction of different persons with the process itself. A 3D-Software as a planning tool could take human and economic factors into account and therefore could provide additional support.

The aim of our evaluation is to examine the potentials of 3D-process simulation software in healthcare.

Methods: We developed two case studies based on two daily processes in hospitals: Food supply (1), pharmaceutical provision (2). Based on six hours of training (software, evaluation tools for time/costs/ergonomics), the students' task was to develop a to-be process on the basis of suggested modifications as well as the subsequent and/or parallel implementation in the software. Additionally, they should critically evaluate the software during its application (six weeks). The students were divided into two groups, one with an affinity for technology and the other with a rather low affinity.

EmaWD is a process simulation software [3]. It was developed for the automotive industry and is able to simulate work processes according to economic (e.g. MTM-UAS) and ergonomic (e.g. EAWS) aspects. EmaWD enables the virtual design of work systems including human work activities and considers human-robot-collaboration.

Results: The results of the first case study show a considerable reduction of walkpaths: modification 1 shows a reduction of 671 m/hour, modification 2 of 799 m/hour. Modification 3 implies a second nurse and leads to a reduction of 665 m/hour. Parallel to the improvement of the walkpaths, an increase in distributed meals could be achieved. Group two calculated changes assuming that drugs are supplied three times a day. The modifications lead to a walkpath reduction of 54m as wells as a decrease of time required of 107 s. The emaWD has a high degree of customization, so that the environment can be precisely recreated and processes realistically represented. This allows process and structural errors to be identified and optimized. However, the handling of the software is complex and requires a high training period. Despite the various human models, the complexity of individual types of patients and employees cannot be sufficiently taken into account. For both groups, the results of the evaluation were the same.

Discussion: 3D software could add significant value in healthcare and provides resilient results. However, especially in healthcare (older employees, low affinity for technology, low financial resources) the following aspects are relevant: usability, price, simplicity of use. The fact that an expert must be available to use the software is certainly a critical factor in the evaluation.

Conclusion: 3D simulation software in healthcare could contribute to process optimization and for widespread use, emaWD should be user-friendly and adapted to patients and employees.

Figure 1 [Fig. 1]

The authors declare that they have no competing interests.

The authors declare that an ethics committee vote is not required.