Assume that MTL_Clinic is a walk-in only clinic. Walk-in Only means that patients cannot make an appointment
Question:
Assume that MTL_Clinic is a walk-in only clinic. "Walk-in Only" means that patients cannot make an appointment in advance - if they have a health concern, they should arrive at the clinic and wait until their turn to see a doctor. Patients arrive to the clinic according to an exponential distribution with mean 7 minutes. The clinic is open from 8am to 5pm, 7 days a week. Any patient who has entered the system at closing time still has to be served on the same day (this will result in overtime, particularly for nurses and doctors). Upon arrival to the clinic, a patient is first required to obtain a mask and sanitize their hands. Doing so takes between 15 and 30 seconds, uniformly distributed. The patient then sees a receptionist. The receptionist registers the patient by taking their information, such as their medical card number, and asks the patient to wait until they can be seen by a nurse. The time it takes a receptionist to register a patient is distributed according to a triangular distribution with minimum value of 1 minute, a most likely value of 2 minutes, and a maximum of 3 minutes. A nurse sees registered patients in first-come, first-served order. The nurse has several triage tasks: a) measure the patient's weight and blood pressure, b) record their symptoms on the computer, and c) the nurse assesses the symptoms of the patient and assigns priority to the patient for being seen by the doctor. The time the patient spends with the nurse is variable since some patients take a long time to describe all of their symptoms in detail while others have e.g., just one symptom that is quick to take note of. The distribution of time at the nurse therefore can be approximately modelled by a triangular distribution with parameters 2 minutes, 5 minutes and 25 minutes. As part of the assessment, the nurse asks the patient if they are experiencing any pain (approximately 50% of patients say yes); if yes, the patient is asked to assess their pain on a scale of 1 to 10, with 10 being the most severe. If the patient reports a pain of 8 to 10, the nurse calls an ambulance to send the patient to the emergency room; this happens in about 1% of clinic visits. If the patient reports a pain level of 6 or 7, the nurse assigns the patient priority 1 (approximately 25% of the time), while if the patient reports a pain of level 5 or less, priority 2 is assigned which happens in around 74% of clinic visits. Patients with no pain are assigned priority 3 (lowest priority). After seeing the nurse, the patient goes back to the waiting room of the clinic (for patients who have not been sent to the emergency room). Patients are seen by the doctor according to their priority (and according to FCFS within each priority group). The time it takes the doctor to diagnose a patient's condition and/or prescribe next steps is exponentially distributed with mean 15 minutes. After seeing the doctor, three outcomes are possible: 1) the doctor prescribes the patient some medication (30% of patients), 2) the doctor refers the patient to a specialist (20%) or 3) the doctor refers the patient for a blood test (50%). If the patient is assigned a blood test, they go back to the waiting area and wait for a nurse to call them to do the test. The nurses doing blood tests are the same nurses that do the triage (but the patient does *not* have to see exactly the same nurse as triaged them). Blood test patients are treated in FCFS order together with new arrivals (they do not have any priority). The time required for a blood test is distributed according to a continuous uniform distribution with minimum of 7 minutes and maximum of 10 minutes. If no blood test is required, the patient leaves the clinic immediately; if a blood test is required, the patient leaves the clinic after the blood test.
The clinic currently has two receptionists, five nurses and three doctors.
The clinic is interested in estimating the following metrics:
a) waiting time until a patient sees a nurse for triage (from the time of arrival) [note: this is not the time until patient joins the nurse's queue, it is the time until the patient actually starts speaking with the nurse] Note: triage here means the whole process of triage (all three tasks the nurse performs initially when a patient arrives). Triage does not include a blood test.
b) waiting time until a patient sees a doctor (from the time of arrival) by patient type [note: this is not the time until patient joins the doctor's queue, it is the time until the patient actually starts speaking with the doctor]
c) total time in the system per visit (from arrival until leaving the clinic) by patient priority type [hint: using the "record into set" option in the record module will make your model more compact. You do not have use the hint if you do not know how to; there are many ways to correctly model the same concept in Arena.]
d) latest time a patient leaves the clinic (over a week) [hint: you can use a combination of "output" module and built-in functions in Arena in the "build expression" menu. You do not have use the hint if you do not know how to; there are many ways to correctly model the same concept in Arena.] You need to simulate this system for a week, with 20 replications.