Hospital processes within an integrated system view: A hybrid simulation approach

Processes in hospitals or in other healthcare institutions are usually analyzed and optimized isolated for enclosed organizations like single hospital wards or certain clinical pathways. However, many workflows should be considered in a broader scope in order to better represent the reality, i.e., in combination with other processes and in contexts of macro structures. Therefore, an integrated view is necessary which enables to combine different coherences. This can be achieved by hybrid simulation. In this case, processes can be modeled and simulated by discrete simulation techniques (i.e., DES or ABS) at the meso-level. However, holistic structures can be comfortably implemented using continuous methods (i.e., SD). This paper presents a theoretical approach that enables to consider reciprocal influences between processes and higher level entities, but also to combine hospital workflows with other subjects (e.g., ambulance vehicles).