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Införande av one stop clinic - en simuleringsstudie på Klinisk kemi, Helsingborgs lasarett

Larsson, Maria LU and Elmander Vanelli, Victoria LU (2011) MTT920 20102
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Abstract (Swedish)
Klinisk kemi på Helsingborgs lasarett analyserar prover från sjukhuset, kringliggande vårdcentraler och prover från patienter som kommer till den närliggande provtagningscentralen (PTC). En önskan om att erbjuda ett one stop clinic-koncept till ett antal diabetespatienter har växt fram. Det skulle innebära att patienterna kommer för provtagning till PTC och besöker läkaren vid ett och samma tillfälle, i stället för att göra detta separat. I nuläget behövs två besök på lasarettet, med minst ett par dagars mellanrum, eftersom ingen garanti kan ges på hur snabbt proverna kan analyseras. Syftet med den här studien är att ta reda på vilka strukturella förändringar av provernas hanteringssätt som krävs för att möjliggöra detta, samt när i veckan... (More)
Klinisk kemi på Helsingborgs lasarett analyserar prover från sjukhuset, kringliggande vårdcentraler och prover från patienter som kommer till den närliggande provtagningscentralen (PTC). En önskan om att erbjuda ett one stop clinic-koncept till ett antal diabetespatienter har växt fram. Det skulle innebära att patienterna kommer för provtagning till PTC och besöker läkaren vid ett och samma tillfälle, i stället för att göra detta separat. I nuläget behövs två besök på lasarettet, med minst ett par dagars mellanrum, eftersom ingen garanti kan ges på hur snabbt proverna kan analyseras. Syftet med den här studien är att ta reda på vilka strukturella förändringar av provernas hanteringssätt som krävs för att möjliggöra detta, samt när i veckan som konceptet är lämpligast att tillämpa. Då det i framtiden kan bli aktuellt att utöka gruppen patienter som kan erbjudas konceptet, undersöks också vilken kapacitet Klinisk kemi har.
Studien är ett simuleringsprojekt; en modell av det verkliga systemet är uppbyggd med simuleringsmjukvaran AutoMod. Data som beskriver systemet har samlats in vid fältstudier, via intervjuer, observationer, enkäter och från databaser. En konceptuell modell har byggts upp som sedan har blivit till en datormodell. Därefter har förändringar gjorts i modellen för att modellera framtida hanteringssätt som Klinisk kemi kan tänkas införa. Modellen har sedan simulerats under en lång tid, med syftet att generera data angående provernas totala svarstid. Experiment som undersöker lämplig veckodag samt kapaciteten har också utförts med hjälp av modellen.
Resultaten pekade mot att Klinisk kemi behöver göra en rad förändringar för att kunna garantera en svarstid på under en timme för den aktuella patientgruppen. Proven bör tas i direkt anslutning till laboratoriet, så att omvägen via PTC avskaffas. Proven bör också sättas på akutställ i analysmaskinen så att dessa prioriteras före andra prover. Om en längre svarstid på cirka 80 minuter kan anses acceptabel klarar de dock av att patienterna tar proven i PTC men att dessa prioriteras före i provmottagningen. De måste dock även i detta fall sättas på de akutprioriterade ställen.
Klinisk kemi har kapacitet att erbjuda konceptet one stop clinic till ungefär 45 patienter per dag. Om det skulle komma på fråga att införa konceptet under endast en eller några dagar i veckan, är det ingen stor skillnad på vilken dag som passar bäst. Resultaten tyder dock på att det är något lättare att upprätthålla servicenivån i slutet av veckan. (Less)
Abstract
The division of Clinical Chemistry at Helsingborg Hospital analyses human biological samples from the hospital, adjacent care centres and from patients who take the samples at the neighbouring centre (PTC). The division of Clinical Chemistry has a vision of being able to offer a one stop clinic-concept to a group of patients diagnosed with diabetes. This would mean that the patient could take the necessary samples an hour or so prior to seeing the doctor, as oppose to needing two visits at the hospital; one for the sample taking and one for the visit with the doctor. At present, there is no set time limit for the sample analyses, which means that the visits are planned a few days apart. This study’s objective is to establish what changes... (More)
The division of Clinical Chemistry at Helsingborg Hospital analyses human biological samples from the hospital, adjacent care centres and from patients who take the samples at the neighbouring centre (PTC). The division of Clinical Chemistry has a vision of being able to offer a one stop clinic-concept to a group of patients diagnosed with diabetes. This would mean that the patient could take the necessary samples an hour or so prior to seeing the doctor, as oppose to needing two visits at the hospital; one for the sample taking and one for the visit with the doctor. At present, there is no set time limit for the sample analyses, which means that the visits are planned a few days apart. This study’s objective is to establish what changes are needed in order to enable the one stop clinic-concept. In the future, the concept might be expanded to include other patient categories. Hence, the capacity for analysing the patients’ samples with a time limit will be investigated, as well as which days are more favourable for the one stop clinic-concept.
The study was done as a simulation project. A model of the real system was built in the simulation software AutoMod. Data concerning the system was collected by thorough field studies, interviews, observations, questionnaires and from computer databases. A conceptual model was built, and was then converted into a computer model, to which modifications were made to model potential changes at the division of Clinical Chemistry. Simulations were then carried out over a long time span, in order to generate data about the total process time of the samples. Experiments investigating the days’ suitability for the concept, as well as the capacity, were also done.
Results show that the division of Clinical Chemistry needs to make some changes in order to guarantee that the samples of the topical patient group can be analysed within one hour. The samples need to be taken in proximity to the laboratory, instead of at the PTC. They should also be put in the emergency racks when being analysed in the machine and hence be prioritized. If a longer process time of approximately 80 minutes is considered to be acceptable, fewer changes are necessary. The patients can take the samples at the PTC, but the samples must be prioritized in the receiving area and the emergency racks must be used.
The division of Clinical Chemistry has the capacity to offer the one stop clinic-concept to roughly 45 patients a day. If they were to introduce the concept at only one or a few days a week, there is little evidence that one day is better than the other. The simulations’ results indicate only a slightly better performance at the latter days of the week. (Less)
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author
Larsson, Maria LU and Elmander Vanelli, Victoria LU
supervisor
organization
alternative title
Introduction of a One Stop Clinic – a Simulation Study at the Division of Clinical Chemistry, Helsingborg Hospital
course
MTT920 20102
year
type
H2 - Master's Degree (Two Years)
subject
keywords
One stop clinic, AutoMod, Statistisk modellering, Händelsestyrd simulering, Klinisk kemi, Modellering av data
ISSN
LUTMDN/TMFL–10/5087–SE
language
Swedish
id
1769989
date added to LUP
2011-01-27 12:26:01
date last changed
2011-01-27 12:26:01
@misc{1769989,
  abstract     = {The division of Clinical Chemistry at Helsingborg Hospital analyses human biological samples from the hospital, adjacent care centres and from patients who take the samples at the neighbouring centre (PTC). The division of Clinical Chemistry has a vision of being able to offer a one stop clinic-concept to a group of patients diagnosed with diabetes. This would mean that the patient could take the necessary samples an hour or so prior to seeing the doctor, as oppose to needing two visits at the hospital; one for the sample taking and one for the visit with the doctor. At present, there is no set time limit for the sample analyses, which means that the visits are planned a few days apart. This study’s objective is to establish what changes are needed in order to enable the one stop clinic-concept. In the future, the concept might be expanded to include other patient categories. Hence, the capacity for analysing the patients’ samples with a time limit will be investigated, as well as which days are more favourable for the one stop clinic-concept.
The study was done as a simulation project. A model of the real system was built in the simulation software AutoMod. Data concerning the system was collected by thorough field studies, interviews, observations, questionnaires and from computer databases. A conceptual model was built, and was then converted into a computer model, to which modifications were made to model potential changes at the division of Clinical Chemistry. Simulations were then carried out over a long time span, in order to generate data about the total process time of the samples. Experiments investigating the days’ suitability for the concept, as well as the capacity, were also done.
Results show that the division of Clinical Chemistry needs to make some changes in order to guarantee that the samples of the topical patient group can be analysed within one hour. The samples need to be taken in proximity to the laboratory, instead of at the PTC. They should also be put in the emergency racks when being analysed in the machine and hence be prioritized. If a longer process time of approximately 80 minutes is considered to be acceptable, fewer changes are necessary. The patients can take the samples at the PTC, but the samples must be prioritized in the receiving area and the emergency racks must be used.
The division of Clinical Chemistry has the capacity to offer the one stop clinic-concept to roughly 45 patients a day. If they were to introduce the concept at only one or a few days a week, there is little evidence that one day is better than the other. The simulations’ results indicate only a slightly better performance at the latter days of the week.},
  author       = {Larsson, Maria and Elmander Vanelli, Victoria},
  issn         = {LUTMDN/TMFL–10/5087–SE},
  keyword      = {One stop clinic,AutoMod,Statistisk modellering,Händelsestyrd simulering,Klinisk kemi,Modellering av data},
  language     = {swe},
  note         = {Student Paper},
  title        = {Införande av one stop clinic - en simuleringsstudie på Klinisk kemi, Helsingborgs lasarett},
  year         = {2011},
}