Using Discrete Event Simulation (DES) to manage theatre operations in healthcare: An audit-based case study

This paper discusses the application of Discrete Event Simulation (DES) in modelling the complex relationship between patient types, case-mix and operating theatre allocation in a large National Health Service (NHS) Trust in London. The simulation model that was constructed described the main features of nine theatres, focusing on operational processes and patient throughput times. The model was used to test three scenarios of case-mix and to demonstrate the potential of using simulation modelling as a cost effective method for understanding the issues of healthcare operations management and the role of simulation techniques in problem solving. The results indicated that removing all day cases will reduce patient throughput by 23.3% and the utilization of the orthopaedic theatre in particular by 6.5%. This represents a case example of how DES can be used by healthcare managers to inform decision making. © 2008 IEEE.

Mixed nonlinear LES for DES suitable flows

It is shown that a new mixed nonlinear/eddy viscosity LES model reproduces profiles better than a number of competing nonlinear and mixed models for plane channel flow. The objective is an LES method that produces a fully resolved turbulent boundary layer and could be applied to a variety of aerospace problems that are currently studied with RANS, RANS-LES, or DES methods that lack a true turbulent boundary layer. There are two components to the new model. One an eddy viscosity based upon the advected subgrid scale energy and a relatively small coefficient. Second, filtered nonlinear terms based upon the Leray regularization. Coefficients for the eddy viscosity and nonlinear terms come from LES tests in decaying, isotropic turbulence. Using these coefficients, the velocity profile matches measurements data at Reτ ≈ 1000 exactly. Profiles of the components of kinetic energy have the same shape as in the experiment, but the magnitudes differ by about 25%. None of the competing LES gets the shape correct. This method does not require extra operations at the transition between the boundary layer and the interior flow.

High-order DES and zonal LES of a labyrinth seal

Hybrid numerical large eddy simulation (NLES) and detached eddy simulation (DES) methods are assessed on a labyrinth seal geometry. A high sixth order discretization scheme is used and is validated using a test case of a two dimensional vortex. The hybrid approach adopts a new blending function and along with DES is initially validated using a simple cavity flow. The NLES method is also validated outside of RANS zones. It is found that there is very little resolved turbulence in the cavity for the DES simulation. For the labyrinth seal calculations the DES approach is problematic giving virtually no resolved turbulence content. It is seen that over the tooth tips the extent of the LES region is small and is likely to be a strong contributor to excessive flow damping in these regions. On the other hand the zonal Hamilton-Jacobi approach did not suffer from this trait. In both cases the meshes used are considered to be hybrid RANS-LES adequate. Fortunately (or perhaps unfortunately) the DES profiles are in agreement with the time mean experimental measurements. It is concluded that for an inexperienced CFD practitioner this could have wider implications particularly if transient results such as unsteady loading are desired. Copyright © 2012 by the American Institute of Aeronautics and Astronautics, Inc.