Simulating the impact of facility design on operations: a study in an internal medicine ward

Abstract

PurposeThis study aims to use a narrative-based simulation approach to explore potential implications of including or excluding a dayroom in the design of an internal medicine ward.Design/methodology/approachThe approach involved: collecting data in facilities using field observations and experts’ interviews; modeling representative behavior patterns in the form of rule-based narratives that direct collaborative behaviors of virtual occupants; simulating the behavior patterns in two alternative design options, one of which includes a dayroom; and analyzing the simulation results with respect to selected key performance indicators of day-to-day operations and spatial occupancy, including occupant density in corridors, number and locations of staff-visitor interactions and duration of a doctors’ round procedure.FindingsSimulation results suggest that the presence of a dayroom reduces visitors’ density in corridors and diminishes the number of staff–visitor interactions that can delay the performing of scheduled medical procedures.Research limitations/implicationsA high level of uncertainty is intrinsic to the simulation of future human behavior. Additional work is required to systematically collect large volumes of occupancy data in existing facilities, model additional narratives and develop validation protocols to assess the degree of uncertainty of the proposed model.Originality/valueA limited number of studies explore how simulation can be used to study the impact of building design on operations. This study uses a narrative-based approach to address some of the limitations of existing methods, including discrete-event simulations. Preliminary results suggest that the lack of appropriate spaces for patients and visitors to socialize may cause potential disruptions to hospital operations.