Informing Hospital Change Processes through Visualization and Simulation: A Case Study at a Children's Emergency Clinic

Abstract

OBJECTIVE:

To demonstrate the use of visualization and simulation tools in order to involve stakeholders and inform the process in hospital change processes, illustrated by an empirical study from a children's emergency clinic.

BACKGROUND:

Reorganization and redevelopment of a hospital is a complex activity that involves many stakeholders and demands. Visualization and simulation tools have proven useful for involving practitioners and eliciting relevant knowledge. More knowledge is desired about how these tools can be implemented in practice for hospital planning processes.

METHODS:

A participatory planning process including practitioners and researchers was executed over a 3-year period to evaluate a combination of visualization and simulation tools to involve stakeholders in the planning process and to elicit knowledge about needs and requirements.

RESULTS:

The initial clinic proposal from the architect was discarded as a result of the empirical study. Much general knowledge about the needs of the organization was extracted by means of the adopted tools. Some of the tools proved to be more accessible than others for the practitioners participating in the study. The combination of tools added value to the process by presenting information in alternative ways and eliciting questions from different angles.

CONCLUSIONS:

Visualization and simulation tools inform a planning process (or other types of change processes) by providing the means to see beyond present demands and current work structures. Long-term involvement in combination with accessible tools is central for creating a participatory setting where the practitioners' knowledge guides the process.

Keywords

Design process hospital modeling planning work environment

Get full access to this article

View all access options for this article.

References

Al-Kodmany

(2001). Visualization tools and methods for participatory planning and design. Journal of Urban Technology, 8(2), 1–37. doi: 10.1080/106307301316904772

Arnstein

S. R.

(1969). A ladder of citizen participation. Journal of the American Institute of Planners, 35(4), 216–224. doi: 10.1080/01944366908977225

Cahill

, & Render

(1999, December). Dynamic simulation modeling of ICU bed availability. Paper presented at the Winter Simulation Conference Proceedings, Phoenix, AZ.

Carlson

R. C.

Hershey

J. C.

, & Kropp

D. H.

(1979). Use of optimization and simulation models to analyze outpatient healthcare settings. Decision Sciences, 10(3), 412–433. doi: 10.1111/j.1540-5915.1979.tb00035.x

Davies

(2002). Applications of system design using virtual environments. In Hale

K. S.

& Stanney

K. M.

(Eds.), Handbook of virtual environments: Design, Implementation, and applications (pp. 1079–1100). Mahwah, NJ: Lawrence Erlbaum Associates.

Dunston

Arns

McGlothlin

Lasker

, & Kushner

(2011). An immersive virtual reality mock-up for design review of hospital patient rooms. In Wang

& Tsai

J.-H.

(Eds.), Collaborative design in virtual environments (Vol. 48, pp. 167–176). Dordrecht, Netherlands: Springer Science+Business Media B.V.

Ehn

Kyng

, & Bjerknes

(1987). Computers and democracy: A Scandinavian challenge. Aldershot, England: Avebury Publishers.

England

, & Roberts

S. D.

(1978). Applications of computer simulation in health care. Paper presented at the Proceedings of the 10th conference on Winter simulation (Vol. 2), Miami Beach, FL.

Fröst

, & Warren

(2000). Virtual reality used in a collaborative architectural design process. Paper presented at the IEEE International Conference on Information Visualization.

10.

Holmdahl

, & Lanbeck

(2013). Design for the post-antibiotic era: Experiences from a new building for infectious diseases in Malmö, Sweden. Health Environments Research & Design Journal, 6(4), 27–52.

11.

Hornyánszky Dalholm

(1998). To design your space, full-scale modelling in participatory design (Doctoral thesis), Lund University, Lund, Sweden.

12.

Jacobson

Hall

, & Swisher

(2013). Discrete-event simulation of health care systems. In Hall

(Ed.), Patient flow (Vol. 206, pp. 273–309): New York, NY: Springer Science+Business Media LLC.

13.

Kelsick

Vance

J. M.

Buhr

, & Moller

(2003). Discrete event simulation implemented in avirtual environment. Journal of Mechanical Design, 125(3), 428–433. doi: 10.1115/1.1587745

14.

Koning

A. H. J.

(2011). How 3D immersive visualization is changing medical diagnostics. Paper presented at the Human Vision and Electronic Imaging, San Fransisco, CA.

15.

Lawrence

R. J.

(1993). Architectural design tools: Simulation, communication and negotiation. Design Studies, 14(3), 299–313. doi: 10.1016/0142-694X(93)80026-9

16.

Peavey

E. K.

Zoss

, & Watkins

(2012). Simulation and mock-up research methods to enhance design decision making. Health Environments Research & Design Journal, 5(3), 133–144.

17.

Raunak

Osterweil

Wise

Clarke

, & Henneman

(2009). Simulating patient flow through an emergency department using process-driven discrete event simulation. Paper presented at the Software Engineering in Health Care, May 18–19, 2009.

18.

Rechel

Wright

Edwards

Dowdeswell

, & McKee

(Eds.). (2009). Investing in hospitals of the future. Brussels, Belgium: The European Observatory on Health Systems and Policies.

19.

Rogers

Sharp

, & Preece

(2011). Interaction design: Beyond human-computer interaction (3rd ed.). Chichester, England: Wiley.

20.

Rudd

Stern

, & Isensee

(1996). Low vs. high-fidelity prototyping debate. Interactions, 3(1), 76–85. doi: 10.1145/223500.223514

21.

Sanoff

(2000). Community participation methods in design and planning. New York, NY: Wiley.

22.

Simonsen

, & Robertson

(Eds.). (2013). Routledge international handbook of participatory design. New York, NY: Routledge.

23.

Sobolev

B. G.

Sanchez

, & Vasilakis

(2011). Systematic review of the use of computer simulation modeling of patient flow in surgical care. Journal of Medical Systems, 35(1), 1–16. doi: 10.1007/S10916-009-9336-Z

24.

Wahlström

Aittala

Kotilainen

Yli-Karhu

Porkka

, & Nykänen

(2010). CAVE for collaborative patient room design: Analysis with end-user opinion contrasting method. Virtual Reality, 14(3), 197–211. doi: 10.1007/s10055-009-0138-x

25.

Watkins

Myers

, & Villasante

(2008). Mock-ups as “interactive laboratories”: Mixed methods research using inpatient unit room mock-ups. Health Environments Research & Design Journal, 2(1), 66–81.

26.

Westerdahl

Suneson

Wernemyr

Roupé

Johansson

, & Martin Allwood

(2006). Users' evaluation of a virtual reality architectural model compared with the experience of the completed building. Automation in Construction, 15(2), 150–165. doi: 10.1016/j.autcon.2005.02.010

27.

Persson

Hornyánszky Dalholm

& Johansson

(2014). Informing hospital change processes through visualization and simulation: A case study at a children's emergency clinic. Health Environments Research & Design Journal, 8(1), 45–66.