Sailer, Kerstin;
Utley, Martin;
Pachilova, Rosica;
Fouad, Ahmed Tarek Zaky;
Li, Xiaoming;
Jayaram, Hari;
Foster, Paul J;
(2024)
Lanes, Clusters, Lines of Sight: Modelling diagnostic eyecare clinics to improve patient flow.
(OSF Preprints
).
Center for Open Science: Charlottesville, VA, USA.
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Abstract
Lengthy waiting times for ophthalmology appointments in the UK National Health Service (NHS) increased further in the immediate aftermath of the Covid-19 pandemic, necessitating a different approach to triaging patients safely and at speed. Moorfields Eye Hospital NHS Trust therefore opened an additional diagnostic hub designed with a linear spatial layout and patient flow system, which is analyzed in this paper in comparison to an existing clinic. We integrate direct observations of patient flows, and an architectural layout analysis based on space syntax methods with queuing simulations from operations research and show that the two clinics operate differently and that both clinics have their advantages and disadvantages. The newly opened clinic with a lane system supports flows and coordination by line of sight between stations, which contrasts with a lack of sightlines in the existing clinic. The latter layout with clusters of stations compensates by enabling a more organic flow especially in conjunction with experienced technicians, which is beneficial when the clinic gets busy. When high patient load is simulated in the queuing models, the lane system results in slightly bigger bottlenecks and longer clinic durations. An ideal allocation of the number of stations to diagnostic activities based on clusters is suggested. This work stands in the tradition of combining architectural and operations research. By reflecting on the variability of diagnostic processes found in our observations, we contribute to the understanding of routines as performative. We also add insight to the growing field of evidence-based design, particularly by highlighting the importance of line-of-sight relationships in ophthalmology.
| Type: | Working / discussion paper |
|---|---|
| Title: | Lanes, Clusters, Lines of Sight: Modelling diagnostic eyecare clinics to improve patient flow |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.31219/osf.io/bu8vk |
| Publisher version: | https://doi.org/10.31219/osf.io/bu8vk |
| Language: | English |
| Additional information: | © The Author(s), 2024. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/ |
| Keywords: | space syntax, queuing simulation, outpatient clinic, ophthalmology, clinic layout, architecture |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of the Built Environment UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of the Built Environment > The Bartlett School of Architecture |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10201673 |
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