Methodology for Using Simulation to Optimize Emergency Mass Vaccination Parameters
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Slide 1 :
A Methodology for Using Simulation to Optimize Emergency Mass Vaccination Parameters Arben Asllani Parthasarati Dileepan Lawrence Ettkin Department of ManagementCollege of Business University of Tennessee at ChattanoogaPhone: (423) 425 – 4123 Fax: (423) 425 – 4158 Email: firstname.lastname@example.org Journal of Medical Systems
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2 INTRODUCTION Mass vaccination is a better approach than to isolate and treat infected individuals Simulation is an effective tool to analyze potential design alternatives for vaccination clinics Compared to physical drills it is: Less costly Less time consuming Less disruptive It shows system behavior over time and provides information on multiple performance measures It is visually appealing and engages people’s interests It provides results that are easy to understand and communicate It is a decision making tool for IF-THEN scenario analysis
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3 POTENTIAL MASS VACCINATION SCENARIOS Volume: How many people need to be vaccinated? Speed: How soon people need to be vaccinated?
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4 PRE-MITIGATE Methodology Purpose and Scope Definition Review State and Federal Guidelines Emergency Site Investigation and Data Collection Model Base Scenario Incorporate Data From Physical Drills Test and Validate Base Model IF-THEN Analysis Generate Best Scenario Analyze Output from Best Scenario Test and Compare Results with Emergency Preparedness Guidelines Elaborate on Practical Recommendations
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5 Purpose and Scope Definition Three Purposes Increase capacity of the clinic Reduce time each patient spends in the building Limit the number of people in the building during the vaccination process Scope A County High School which serves as a Mass Vaccination Clinic (MVC) in Case of Emergency
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6 Review State and Federal Guidelines After 9/11, Homeland Security Department developed new guidelines for disaster relief Local Emergency Management Agencies need to have response plans in place Flow Diagrams of these plans were used for modeling Goal: Vaccinate 50,000 people in less then 3 days High-speed/High Volume Scenario is used as a base model
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7 Emergency Site Investigation and Data Collection
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8 Emergency Site Investigation and Data Collection (cont.) Sources of Data Historical Records Medical Records Personal Observations School Records Type of Data Patient Arrival Patterns and Distributions Resources Doctors Nurses Vehicles Number of Vaccines Greeters Drivers Janitors Patient Flow Actual Geographic Flow Distance and Time between Workstations Type of Patients Regular Special Needs
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9 Model Base Scenario Software Used: ProModel® Base Model: High-Speed/High-Volume Entities Patients Locations registration video rooms vaccination booth etc. Process Flow See Figure in slide number 7 Resources Vehicles Nurses Doctors Greeters etc.
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10 Incorporate Data From Physical DrillsANDTest and Validate Base Model Data from After Action Report Observed data from Physical Drill Test and Validate the Base Model Using physical drill data we tested Time to vaccinate 700 patients who participated in the physical drill Average time spent by patients (entities) in the MVC Resource utilization such as nurses, doctors, and vehicles Average number of patients in the MVC at any given time during the exercise
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11 IF-THEN Analysis Independent Variables: Outside the control of decision maker Type of medical situation (Influenza, anthrax and so on) Infected time and region Population age Dependent Variables Size of target population Average arrival times Process flow times Medication and other processing times Portion of population requiring special treatment Decision Variables Number of buses available Number of resources in each stage Patient flow path Capacity of TV/Video rooms
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12 Generate Best Scenario Improving Existing Model via IF-THEN Analysis Simulation Runner Component of ProModel® Several combination of decision variables are replicated to ensure statistical significance Best Combination of decision-variables are selected to generate optimal scenario
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13 Analyze Output from Best ScenarioANDTest and Compare Results Best scenario is compared with base scenario for statistical significance with respect to: Time to vaccinate target population Average time a patient spends in the MVC Maximum number of patients in the MVC at any time Best Scenario is compared with paper plans for statistical significance with respect to: Time to vaccinate target population Average time a patient spends in the MVC Maximum number of patients in the MVC at any time Improved solution is able to process between 19-24% more patients
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14 Elaborate on Practical Recommendations Other Recommendations: Arrival patterns and outside traffic flow Significant impact in the system performance Needs further simulation study Staff and Volunteers More is not always better More “Exit review staff” eliminated bottleneck Time required to administer a vaccine has significant impact Number of vaccination stations has no significant impact
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15 Conclusions There is a need to test and validate emergency preparedness plans PRE-MITIGATE Step-by-step methodology to be used by emergency practitioners Should be used in addition to physical drills Can be used to point out deficiencies Can be used to test alternative plans
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PowerPoint Slide Presentation on This research uses simulation software to validate mass vaccinatio
PowerPoint Slide Presentation on This research uses simulation software to validate mass vaccination emergency plans and to suggest changes and improvements. Applying the methodoly in a real case scenario suggested an increase of 19024 percent in the number of people being vaccinated. The proposed methodology can be adjusted for other emergency preparedness scenarios.
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