Simulated co-location of patients admitted to an inpatient internal medicine teaching unit: Potential impacts on efficiency and physician-nurse collaboration

Blair Bilodeau, David Stanford, Mark Goldszmidt, Andrew Appleton


For my first undergraduate student research award, I built a simulation of patient flow through the internal medicine ward at London’s university hospital. Here is the abstract from our submission to INFOR, which has just been resubmitted following review and a request for minor changes.

Effective communication between nurses and physician teams on the internal medicine unit is crucial for high quality, safe, and efficient patient care. In our hospital of interest, a large academic health sciences centre, the physical layout of the unit, current admission process, and the presence of three separate physician teams contribute to uneven workload and communication barriers. We aimed to ad- dress this by physically co-locating each physician teams’ patients so as to facilitate physician-nurse collaboration, and more evenly distribute workload across all three teams. Based upon one year of real-world data, we developed a simulation model of inpatient flow through the internal medicine unit and determined the impact of two proposed changes: co-locating each team’s patients, and new admission rules for how patients are assigned to those teams. Under the new arrangement, each physician team would interact with roughly half the number of nurses, and nurses in turn would have fewer individual team members with whom to communicate, thereby improving effective communication and increasing time for direct patient care for both physicians and nurses.

I presented this work at ORAHS in Oslo, Norway and CanQueue in Edmonton, Canada this past summer. I hope to add some more detail to this page detailing our methodology and results once the paper has been accepted.