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PATIENT CARE SERVICE DELIVERY SYSTEM USING TIMED COLOURED PETRI NETS

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PATIENT CARE SERVICE DELIVERY  SYSTEM USING TIMED COLOURED PETRI NETS

CHAPTER ONE

INTRODUCTION

 

1.1       General Overview

Hospital organization is today an essential part of the medical care scheme. Owing to the increasing complexity of medical sciences, it is very necessary that medical practitioners and specialists should be able to rely on a sound hospital service. Furthermore, there is general agreement on the active role the modern hospital has to play in health and social welfare programs, and on its influence on economic development. In the light of the rapid changes occurring in most of the countries of the world, it seems more and more urgent for them to have at hand basic information on the problem related to hospital planning and administration (WHO, 1966).

Strengthening service delivery is a key strategy to achieve the Millennium Development Goals. Thisincludes the delivery of interventions to reduce child mortality, maternal mortality, and the burden to cancer, tuberculosis, malaria and other emergency cases that claim the lives of many Nigerians. Health care Service provision or delivery is an immediate output of theinputs into the health system, such as health workforce, procurement and supplies and finances.Increased inputs should lead to improved service delivery and enhanced access to services. Ensuringavailability and access to health services is one of the main functions of a health system. SuchServices should meet a minimum quality standard (WHO, 2000).

Monitoring service delivery is not about the coverage of interventions, which is defined as the proportion of people who receive a specific intervention or service among those who need it. Coverage depends on service delivery and the utilization of theService by the target population.Monitoring service delivery has immediate relevance for the management of health services, whichdistinguishes this area from other health systems building blocks. Shortages of drugs, unevendistribution of health services, poor availability of equipment or guidelines such as patientswaiting time, length of stay, and resource utilization rate must all addressed as partof basic service management.

As demand for improved medical care increases, hospitals are facing problems such as overcrowding and dissatisfaction. Improving the key performance indicators of emergency department has been the focal point of healthcare management.Hospital service delivery are facing different problems which affect their performance of these, overcrowding is a common issue around the world  which provide patient with long length of stay, waiting time for receiving services and then dissatisfaction. Most hospitals are under growing demand, they are often faced with insufficient staffing. One solution to the problem is to increase the capacity of hospitals by providing adequate facilities and man power, but this is not the best approach for solving the problem and perhaps not achievable. Recently, the need for improvement in hospitals process due to cost, overcrowding and safety of patient admitted to a large extent, to improving the efficiency and quality of hospital process different methods are used which include process mapping, demand management, critical part identification, queuing systems, statistical forecasting balanced scorecard and computer simulation.

Modelling is a universal technique that can be used across many of the activities in system development. Many modelling languages have been suggested, and many are being used for system development but Petri Nets have been proving to be a powerful modelling tool for various kinds of discreet systems (Murata, 1989; Peterson, 1981), and its formalism provides a clear means for presenting simulation and control logic. Hence, Petri Nets formalism becomes a right candidate for modelling hospital service delivery system.

Coloured Petri nets (CPN) is a graphical oriented language for modelling and validation of systems in which communication, synchronization and resource sharing and resources allocation in needed. It is an example of high level Petri nets which combines the strength of Petri nets with the strength of programming languages. That is, Petri nets provide the primitives for describing synchronization of concurrent processes, while programming languages provide the primitive for definition of data types and manipulation of their data values. The inclusion of time concepts into a Coloured Petri Net model results in a model called Timed Coloured Petri Nets (TCPN) model (Ganiyu et al., 2011a). Thus, with a Timed Coloured Petri Nets, it would be possible to calculate length of stay of patients on the queue, and the amount of time it takes nurses to attend to patients with different cases.

 

1.2       Statement of the Problem

            In hospitals, direct service delivery is offered by medical practitioners, which involves attending to different cases from different patients. As the demand for quality service delivery in healthcare increases (which includes minimum length of stay on the service queue), it becomes very important that many health service services providers (hospitals) require optimal number of personnel/ staff to help them. Emergency patients often expect to receive treatment with minimum delay and in a timely manner. Lack of resource capacity, such as beds, doctors and nurses will hamper the care process and reduce health care quality, as well as increasing the potential of medical errors and long waiting times. This scenario is inherently difficult because in hospital, capacity decision is a major determinant for providing services over a specified time interval (Norazura, 2012).

The previous areas of research focused on the modelling and simulation of emergency department capacity estimation, which determines the optimum number of personnel and physical resources as well as emergency department planning (Nagula,2006).  This research work employed Timed Coloured Petri Nets formalism to model and simulate a patient care service delivery system which is characterized by emergency, inpatient and outpatient cases using Oyo State General Hospital, Fiditi, as a case study.

 

1.3       Aim and Objectives

The aim of this research work is to model and simulate a patient care service delivery            system using Timed Coloured Petri Nets.

The specific objectives are to:

  1. develop a Timed Coloured Petri Net (TCPN) model for a patient care service delivery   system using Oyo State General Hospital, Fiditi, as a case study;
  2. simulate the developed model using CPN tools;
  • validate the developed model on the basis of the simulated and the measured patient      queue and average waiting time;

 

1.4       Significance of the Study

In this field of study, a concept is not studied directly but through a model of the system. By the manipulation of the representation, it is hoped that new knowledge about the modelled system can be obtained without danger, cost or inconvenience of manipulating the real system itself. Thus, the developed Timed Coloured Petri Nets model through its simulation could help in studying and improving patient care service delivery system of a named hospital.

 

1.5       Scope of the Study

In this project work, Timed Coloured Petri Nets was mainly used to model hospital service delivery with the use of CPN tools to simulate the model. Also, statistical analysis was carried out to validate the model.

 

1.6       Methodology

The methods of the study employed in this research work are as follows:

  1. Establishment of a theoretical foundation for the research through a sound literature
  2. Distribution and administration of Questionnaires.
  • Identification of Patient service delivery process.
  1. Development of a model for the process.
  2. The use of Timed Coloured Petri Nets tools to simulate the developed model.
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