Conclusions
This paper investigated an actual healthcare system in which patients experienced difficulty accessing SLP services. Current wait times were well in excess of one year, and one-tenth of patients did not even get assessed due to waiting. Only one-quarter of the treatments that could be feasibly delivered to patients prior to their fifth birthday were completed.
Simulation gave us a valuable, structured approach by which to analyze patient flow and system capacity issues. We were able to demonstrate how different strategies would most likely play out in the real system before physically making the changes. Our modeling predicted that providing treatments to more patients in groups would lead to substantial improvement. This measure is especially favorable since it does not require additional resources to the system, a particularly troublesome issue within this health region. The most intensive option for group treatment that we tested assumes that 75 percent of patients are treated in a group, and the group has 3–5 patients. While SLP therapists were con- fident that this was possible, it would have to be field tested to verify that patients progress as well as if they had individual treatments.
If the goal of quality improvement is to eliminate waiting time and ensure that all patients are adequately assessed, then our analysis showed that additional change strategies requiring more resources will be required. Quadrupling the number of SLPs could accomplish this goal. However, an alternate, less re- source intensive strategy would be to add one SLP, deploy para- professionals, and maximize use of group visits as described above.