Enhancing staffing methods and improving the admission process of a psychiatric hospital using simulation

This study considers how patients with severe mental illness are referred to a psychiatric hospital from outpatient settings, community mental health centers, or general hospitals. Due to the complexities of many of the patients, the referral process has multiple steps and was experiencing significant delays that both hindered patient care and drove up system costs. The combination of a multistage patient assessment process and the need to observe patients prior to transfer create unique system constraints and objectives. An investigation of potential root causes of admissions process delay determined that insufficient capacity in the Mental Health Disorder Identification (MHDI) process was the primary cause. Discrete event simulation was used to analyze eight different capacity scenarios for MHDI resulting in a recommendation to increase daily MHDI capacity and to provide backup capacity to cover staff vacation days, the latter being one of the more important findings. The simulation model is also used to assess what capacity improvements are required to keep PM times low for up to a 25% increase in the patient arrival rate.