Utilization of discrete event simulation in the prospective determination of optimal cardiovascular lab processes

The clinical character of cardiovascular disease creates challenges in optimizing cardiovascular catheterization lab (CVL) throughput. These challenges are due to case load fluctuations caused by unscheduled Emergency Department patients and simultaneous conflicting demands on cardiologist time. The simulation model provides insight into the complex relationship between patient acuity, treatment, occurrence of queues and bottlenecks in the transfer of patients. The study performed a comparative analysis between CVL operational schemes and assessed how those schemes impacted a variety of metrics related to throughput improvement. A current state model was developed, pertinent data was collected for the patient group and validation of the model was performed. Analysis of simulation results determined the most efficient CVL schedule and resource allocation to improve throughput and resource utilization. The study provides objective guidance to the optimal process modification and allows comparison of the relative differences in cost between the several redesign options.