060 The development of a stroke unit simulation model to reconfigure an inpatient stroke unit

Published Date: 24th October 2015

Publication Authors: Hill AM

Summary
Our team developed a mathematical simulation of a stroke unit, allowing us to demonstrate the optimal size and configuration for a stroke unit. The model utilised existing known inputs: including the number of strokes, stroke ‘mimics’, TIAs, and optionally the presence of medical outliers on the stroke unit. For each group we also looked at the time of arrival and length of stay. The simulation simulates ‘bed days’: during each day patients present with the same arrival distribution as our current patient population. Where possible they are allocated to the stroke unit, if not they outlie to a medical ward. Outlying strokes are ‘repatriated’ to the stroke unit as soon as a bed is available. The model allowed configuration of the number of beds, as well as number of strokes, mimics and presence of outliers. Its outputs looked at the proportion of patients admitted within 4 hours (assuming capacity as the only barrier); proportion spending 90% of time on the unit; and bed occupancy. We utilised this model to support the business case for expansion of our unit by 10 beds and a strict prevention of outlying medical patients. The redesigned unit was able to meet both 4 hour admission and 90% stay measures. It permitted discussion at executive/CCG level of how bed management influences a stroke service and the magnitude of the ‘cluster’ effect seen with stroke unit admissions.

 

Hill, AM. (2015). 060 The development of a stroke unit simulation model to reconfigure an inpatient stroke unit. International Journal of Stroke. 10 (5), 36

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