Lean implementation and pediatric intensive care unit bed availability analysis via simulation at the Winnipeg Children’s Hospital

The Winnipeg Children’s Hospital encounters delays within the surgical patient flow and cancellations due to a lack of available resources in the Pediatric Intensive Care Unit (PICU). Applying the concepts of lean thinking and the practices of simulation and statistical analysis, these problems were better understood and solutions were developed. Improvement projects were performed centralized on lean concepts and utilizing the tools of value-stream mapping and 7 forms of waste. Building and running a simulation model provided a capacity versus demand measure for the overall performance of the PICU. Simulation allowed for the study of hypothetical situations such as varying department resources and fluctuating patient levels. Statistical calculations were used to create a prediction tool to determine the probability of a PICU bed being available. This would enable a reduction in last-minute cancellations of surgical cases requiring a PICU bed.