Process Modeling at Excalibur

In medicine, until the development of the van Leeuwenhoek microscope, microorganisms could not be seen. Similarly in healthcare systems, until the “lens of Process Simulation” was available, process mapping techniques described only the symptoms of poor performance and could not clearly see the underlying causes.

Previous process documentation and analysis methods (whether manual or electronic) are simply inadequate to comprehensively document, understand, analyze and optimize a process, especially a healthcare process. They are merely static two dimensional representations of a process. They include in their various forms:

Flowcharting

Process mapping

Value Stream Mapping

The healthcare analogy we use is that previous process mapping tools are like an x-ray. Useful as a low resolution two dimensional diagnostic tool. Process modeling is like an MRI, providing a level of process resolution previously not possible.

“Anyone who presumes to improve a process without a comprehensive understanding of the system in which it operates is doing no more than “tampering” with that process. Indeed, some process changes which have been described as improvements have only moved the problem to some other point in the system, replaced the old problems with new ones or made the problem worse”

Excalibur’s partner, Empirical Solutions, is one of the most capable and effective process modeling consulting services in the field of healthcare. With dynamic process modeling, for the first time ever we can:

Comprehensively document a process
See and understand "interactions" in a process that are otherwise "invisible", very similar to seeing interactions in a statistically designed experiment
See the different multiple constraints that appear under different conditions in the process
Optimize the process given several simultaneous goals (example: time, staffing, space, cost)
Predict with high confidence the result of proposed improvements in the process
Accurately prioritize and sequence any series of planned improvements
Use the "logic" from the model to guide real time management decisions about the process such as what is the appropriate staffing for the process under different patient volumes and acuity levels or case mix
Achieve levels of process performance not possible by Lean or Six Sigma alone

A Value Stream or Process Map is adequate for many simple, linear processes. It is however only with dynamic process modeling and simulation that we are able to effectively analyze and optimize the performance of a healthcare process. Process Modeling and Simulation allows us to accurately see critical dependencies, interactions and constraints between process events that are impossible to see with any other manual process mapping approach.

Dynamic Process Simulation has many applications in Healthcare. It may be used to accurately predict and quantify the effects of internally proposed process improvements or externally mandated process changes. It may be used to prioritize the impact and ideal sequence of implementing each of proposed process change. It may also be used to determine the required level of staffing of a process to support a target length of stay given the anticipated demand for a process (as in the case of the Emergency Department).