Using queuing theory and simulation model to optimize hospital pharmacy performance.
BACKGROUND
Hospital pharmacy is responsible for controlling and monitoring the medication use process and ensures the timely access to safe, effective and economical use of drugs and medicines for patients and hospital staff.


OBJECTIVE
This study aimed to optimize the management of studied outpatient pharmacy by developing suitable queuing theory and simulation technique.


METHODS
A descriptive-analytical study conducted in a military hospital in Iran, Tehran in 2013. A sample of 220 patients referred to the outpatient pharmacy of the hospital in two shifts, morning and evening, was selected to collect the necessary data to determine the arrival rate, service rate, and other data needed to calculate the patients flow and queuing network performance variables. After the initial analysis of collected data using the software SPSS 18, the pharmacy queuing network performance indicators were calculated for both shifts. Then, based on collected data and to provide appropriate solutions, the queuing system of current situation for both shifts was modeled and simulated using the software ARENA 12 and 4 scenarios were explored.


RESULTS
Results showed that the queue characteristics of the studied pharmacy during the situation analysis were very undesirable in both morning and evening shifts. The average numbers of patients in the pharmacy were 19.21 and 14.66 in the morning and evening, respectively. The average times spent in the system by clients were 39 minutes in the morning and 35 minutes in the evening. The system utilization in the morning and evening were, respectively, 25% and 21%. The simulation results showed that reducing the staff in the morning from 2 to 1 in the receiving prescriptions stage didn't change the queue performance indicators. Increasing one staff in filling prescription drugs could cause a decrease of 10 persons in the average queue length and 18 minutes and 14 seconds in the average waiting time. On the other hand, simulation results showed that in the evening, decreasing the staff from 2 to 1 in the delivery of prescription drugs, changed the queue performance indicators very little. Increasing a staff to fill prescription drugs could cause a decrease of 5 persons in the average queue length and 8 minutes and 44 seconds in the average waiting time.


CONCLUSIONS
The patients' waiting times and the number of patients waiting to receive services in both shifts could be reduced by using multitasking persons and reallocating them to the time-consuming stage of filling prescriptions, using queuing theory and simulation techniques.
Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
Mohammadkarim
M
Bahadori
Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
Seyed Mohsen
SM
Mohammadnejhad
School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran.
Ramin
R
Ravangard
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran.
Ehsan
E
Teymourzadeh
Hospitals; Patient Simulation; Pharmacy; Queuing Theory