Lean ICU Layout Re-Design: A Simulation-Based Approach

Healthcare facilities require flexible layouts that can adapt quickly in the face of variousdisruptions. COVID-19 confirmed this need for both healthcare and manufacturing systems. Startingwith the transfer of decision support systems from manufacturing, this paper generalizes layoutre-design activities for complex systems by presenting a simulation framework. Through a real casestudy concerning the proliferation of nosocomial cross-infection in an intensive care unit (ICU), themodel developed in systems dynamics, based on a zero order immediate logic, allows reproducingthe evolution of the different agencies (e.g., physicians, nurses, ancillary workers, patients), as well asof the cyber-technical side of the ICU, in its general but also local aspects. The entire global workflowis theoretically founded on lean principles, with the goal of balancing the need for minimal patientthroughput time and maximum efficiency by optimizing the resources used during the process. Theproposed framework might be transferred to other wards with minimal adjustments; hence, it hasthe potential to represent the initial step for a modular depiction of an entire healthcare facility.