Behavior-oriented Hospital Space And Process Simulation Optimization And Decision-making

The contradictions between supply and demand of hospital services in China are very prominent.This is not only a contradiction in the service quantity stemming from the relative lack of resources,but more prominently in the service quality.The existing level of hospital services cannot satisfy the people’s growing urgent demand for highquality services.The unreasonable design of hospital building and service system,the sloppy management of hospital construction and operation,and many other factors have caused poor patient experience and satisfaction.Under the reality of contradictions between supply and demand,improving hospital service performance is an important practical problem that needs to be solved in the current hospital construction and service operation management.This paper takes hospital service system as the research object,bases on practical needs and "problem-oriented" research ideology,and makes comprehensive application of management science,engineering management,building behavior,information science and other discipline theories,as well as operation research,computational experiments,intelligent optimization algorithms,BIM and other methods and technical tools to carry out interdisciplinary research.Hospital service is a professional activity carried out in a certain set of spatial and technological conditions.Hospital space,medical processes and other mutually coupled elements together constitute a complex hospital service system.Hospital space functions as the physical foundation for hospital services,while medical processes establish the procedural guidelines for both hospitals in delivering medical care and patients in seeking treatment.By analyzing user behaviors through a service process lens,we identify three primary behavioral patterns exhibited by patients during their hospital visits: medical behaviors,encompassing the various medical activities patients undertake in accordance with established processes;mobility behaviors,referring to patients’ movements and displacements within the hospital environment during their visit;and wayfinding behaviors,which involve patients navigating and locating specific areas within the intricate hospital layout.Hospitals,as the service providers,rely on the well-orchestrated medical processes and the availability of diverse medical resources to execute their service offerings.Fundamentally,enhancing hospital service performance is contingent on optimizing these user behaviors.Leveraging complex system theory,this study innovatively examines the interconnectedness between hospital space,medical processes,and user behaviors.Therefore,this paper conducts specific research on four typical scenario problems in the context of medical behavior,mobility behavior,wayfinding behavior,and service behavior orientation.The main research of this paper is as follows.(1)Spatial-process coupling and its effect on user behavior.Based on ontological thinking,an ontological model of space-process-behavior(SPB)is constructed,and the definition of tuple class attributes and the interpretation of association relationships in the SPB ontological model provide an insightful epistemological explanation for understanding the process of space-process interaction coupling and its ultimate effect on various user behaviors.At the same time,the class attribute definitions of the ontology relationship model are also the data structure basis for the simulation modeling of service systems in the subsequent scenario problem studies.(2)Medical behavior-oriented spatial layout design decisions.The study evaluates spatial layout alternatives from the perspective of improving medical behaviors during patient visits.The study defines a spatial layout decision-making framework based on a system simulation approach,and quantitatively evaluates the performance of different alternatives on medical behavior during patient visits by applying a discrete event simulation(DES)approach to simulate hospital service operations and patient visits.The study validates the feasibility of the proposed framework and methodology with a case study of an outpatient orthopedic department’s layout decision,and also elaborates the simulation modeling procedures of the hospital service spatial system,process system and behavioral system.(3)Mobility behavior-oriented space layout design diagnosis.The study aims to consider whether the space layout is compatible with the process to ensure the ease of movement of patients within the building space during the consultation process.A spatial layout diagnosis framework was developed to analyze the identification of layout design "bottlenecks" from a network perspective.Firstly,a data mining program is developed to automatically extract and process activity information from patient visit logs to form a patient visit activity network;secondly,a Revit platform plug-in is developed to automatically extract BIM model entity information and apply an improved shortest path algorithm to calculate the relevant attribute values of paths between pairs of activity points in the visit activity network;finally,a layout design diagnostic analysis model is constructed.The bottleneck identification and cause analysis of the layout is based on the movement path network containing the path attribute information.The framework and model are validated by the selected case of an outpatient complex building.(4)Wayfinding behavior-oriented spatial signage layout optimization.A spatial signage layout design framework is defined and BIM and pedestrian simulation methods are used to predict the spatial usage distribution of users traveling to different destinations in an ideal wayfinding scenario.A mathematical optimization model optimizes the visibility of spatial signage based on this distribution.The core logic of the optimization model is to improve the match between the spatial usage distribution(i.e.,the user’s need for wayfinding information)and the spatial sign coverage area(i.e.,the navigation information provided by the spatial sign).The spatial sign coverage is obtained from a parsing model that expresses the perceptual interaction between users and spatial signs.An outpatient lobby was selected for the case study.Simulation models and a VR-based navigational pathfinding experiment verified shorter user pathfinding times and higher user satisfaction in the optimized layout.(5)Service behavior-oriented resource allocation decisions for healthcare processes.The study defines a resource allocation decision framework that incorporates consideration of decision style heterogeneity,with a hybrid decision model at its core.Discrete-event simulation methods were used to characterize the behavioral activities of patient visits and to estimate the service performance of resource allocation alternatives under different operational scenarios.A mathematical model integrating the partitioned multi-objective risk method(PMRM)and the sensitivity index method(USIM)was used to compare the robust performance of resourcing alternatives under uncertainty.A real-world case project in gastroenterology supports the effectiveness of the proposed framework and modeling approach in aiding resource allocation decisions.This study is an interdisciplinary study on the coupling of hospital service system elements and performance improvement,which is forward-looking and innovative in theory and methodology,while focusing on the practicality of the research results.The research is important for enriching and improving the theories of complex operation management and healthcare services,as well as improving the effectiveness,service quality and safety of healthcare services in China,adapting to the new complex situation of rapid changes,improving the satisfaction of doctors and patients,and promoting the realization of the "Health China Strategy".