Healthcare Quality in Focus: Decision-Making in the Face of Variation & Uncertainty
MD Anderson Cancer Center’s new Ambulatory Clinic Building (ACB) was to open in late 2004. Five major outpatient clinics were scheduled to occupy this new facility, along with ancillary services.
Decision making about space allocation and rooms for these clinics was driven on two levels.
- Strategic – The uncertain number of total patient visits forecasted for the move-in date, 2004, and five years after that, 2009.
- Operational – The varying number of patients seen daily and by the varying amount of time patients spend in the rooms.
They used a Monte Carlo simulation to determine the critical output probability distribution: number of exam rooms for a targeted room utilization rate. Risk was quantified as the percent of time each clinic would have to operate above the targeted room utilization, for a given number of rooms, in order to see all patients in a nominal eight-hour day. Consequence is defined as the estimated cost (facilities and staff) due to that risk.
The results prompted the clinics to rethink their operations. It was apparent that no clinic could grow under the operational status quo, and expect that any reasonable number of rooms would suffice — especially in 2009. Efforts are now underway to decrease variation and increase room utilization in the clinics.
Discover how MD Anderson Cancer Center’s experience can help you effectively make decisions in the face of variation and uncertainty.
Presenter
Wayne Fischer, Ph.D., Perioperative Quality Analyst, U. of Texas M. D. Anderson Cancer Center
