Optimizing Patient Flow in the Outpatient Departments of Bangladeshi Public Hospitals Using Arena Simulation and the Elimination of NonValue-Added Tasks
Md. Hasan Ali*, Md. Rahad Laskar, Md Imran Hasan, Tahamina Aktar, Mst. Ifrat Ara Tonni and Mashrur Alam Koushik
ABSTRACT
This research addresses the chronic challenge of patient overcrowding and operational inefficiency within the Outpatient Departments (OPDs) of Bangladeshi government hospitals. By employing Arena-based Discrete Event Simulation (DES), this research pinpoints major operational delays by simulating the unpredictable nature of patient entry and treatment durations. A baseline analysis revealed that peak-hour demand surges of approximately 700% result in 100% resource utilization at manual registration counters, leading to operational gridlock and a 400% escalation in non-productive wait times. To mitigate these delays, the study integrates Lean principles and Value Stream Mapping (VSM) to identify and eliminate Non-Value-Added (NVA) activities. A digital intervention, the "Swift Health Hospital Queue Optimizer," was developed to transit a manual registration to an online triage and appointment scheduling framework. Consequently, post-implementation simulation results demonstrate a transformative 53.40% reduction in average total patient journey time and an 82.61% decrease in NVA time. Furthermore, system throughput more than doubled, showing a 101.8% increase in patients processed. Validated across three distinct healthcare facilities, these findings provide a robust, evidence-based framework for leveraging technology-driven simulation to enhance healthcare capacity and patient-centricity in resource-constrained settings.
