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PATIENT CARE SERVICE DELIVERY SYSTEM USING TIMED COLOURED PETRI NETS

ABSTRACT

In hospitals, patient care service delivery is an important factor that determines the rate of quality service. Most of the existing Patient Care Service Delivery System models reported in literature were majorly to improve service in the emergency department using different performance metrics. However, this research work conceptualized on modelling a patient care service delivery system which is characterized by emergency, inpatient and outpatient cases using Timed Coloured Petri Nets. In developing a Timed Coloured Petri Nets (TCPN) model for a patient care service delivery system, the medical personnel (nurses) and the three categories of patient (emergency, inpatient and outpatient) visiting the Oyo State General Hospital, Fiditi, were used as a case study. The developed Patient Care Service Delivery System (TCPN) model consists of three sections. The first section modelled the three categories of patients and their current states. The second section modelled the Nursing station and how patients were administered by the available nurse(s), while the third section abstracted the nurse-patient service delivery. The developed TCPN model was simulated using CPN tools. The validation of the developed TCPN model was explored by carrying out the statistical analysis between the simulated and the observed average waiting times and queue length of the patients under study. The simulation results of the developed TCPN model revealed the patient average waiting times of 14.5208, 2.9583, 0.9792 and 0.50000 minutes alongside the patient queue length of 27, 6, 5 and 1 as administered by 1, 2, 3 and 4 nurses respectively. Statistically, there were no significant difference between the simulated and the observed average waiting times and the queue lengths of patients under consideration at 5% level. Conclusively, this research work has been able to develop a TCPN model for studying a patient care service delivery system. Also, the developed Timed Coloured Petri Nets model, through its simulation, could help in predicting nurse-patient ratio required for effective patient care service delivery in a named medical center.

CHAPTER ONE

INTRODUCTION

1.1       Background of the Study

Hospital organization is today an essential part of the medical care scheme. Owing to the increasing complexity of medical sciences, it is very necessary that medical practitioners and specialists should be able to rely on a sound hospital service. Furthermore, there is general agreement on the active role the modern hospital has to play in health and social welfare programs, and on its influence on economic development. In the light of the rapid changes occurring in most of the countries of the world, it seems more and more urgent for them to have at hand basic information on the problem related to hospital planning and administration (WHO, 1966).

Strengthening service delivery is a key strategy to achieve the Millennium Development Goals. Thisincludes the delivery of interventions to reduce child mortality, maternal mortality, and the burden to cancer, tuberculosis, malaria and other emergency cases that claim the lives of many Nigerians. Health care Service provision or delivery is an immediate output of theinputs into the health system, such as health workforce, procurement and supplies and finances.Increased inputs should lead to improved service delivery and enhanced access to services. Ensuringavailability and access to health services is one of the main functions of a health system. SuchServices should meet a minimum quality standard (WHO, 2000).

Monitoring service delivery is not about the coverage of interventions, which is defined as the proportion of people who receive a specific intervention or service among those who need it. Coverage depends on service delivery and the utilization of theService by the target population.Monitoring service delivery has immediate relevance for the management of health services, whichdistinguishes this area from other health systems building blocks. Shortages of drugs, unevendistribution of health services, poor availability of

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