P5 Real-World Validation of the Implementation of Healthcare Capacity Optimization Measures Guided by the Simpli Tool: An Ophthalmology Proof of Concept in Portugal


      Hospital services in ophthalmology face significant capacity constraints in Portugal. In 2020, SimPLI – Simulating Capacity Performance Leading to Impact was introduced to assist services in simulating the impact of measures to decrease the backlog of outpatient consultations and procedures. The aim of this work is to introduce the validation of the simulator outputs with the real-world production in a reference ophthalmology center in Portugal.


      A spreadsheet-based simulator was developed for testing measures to accelerate the realization of delayed external consultations and outpatient surgeries. The baseline backlog is represented by the number of delayed procedures. The time to eliminate this backlog was calculated and compared with the output for scenarios where one or more measures were implemented. The number of consultations and procedures simulated at 2020 year-end (YE) was compared with real hospital production data for model validation.


      The implementation of 15-minute telemedicine consultations for follow-up appointments and the reduction in 10 minutes in the time of face-to-face consultations was predicted to increase the number of 1st consultations by 68% and the number of follow-up consultations by 77% in comparison with a scenario without any optimization measures. The time to solve outstanding consultations would be reduced by 7 months. In real practice in the same service, the application of the aforementioned measures was successful, with an additional 58% of 1st consultations and 85% follow-up appointments until 2020 year-end. In outpatient surgeries, the application of measures for capacity optimization reduced by 22% the number of patient lost to private hospitals, with considerable resulting savings.


      SimPLI is invaluable for planning the investment in efficient actions towards optimization of hospital capacity. The proof of concept demonstrates that the proposed measures were validated in real practice with improved provision of care in ophthalmology, eventually resulting in improved patient outcomes.