Article Text

0074 Modelling Medical Procedures Using Engineering Reliability Analysis Techniques
  1. Rasa Remenyte-Prescott1,
  2. Sean Reed1,
  3. Ben Rees2
  1. 1University of Nottingham, Nottingham, UK
  2. 2Nottingham University Hospitals, Nottingham, UK


Context Worldwide evidence has shown that failure to deliver reliable healthcare results in variations in patient outcomes, waste of resources and even harm to patients. For example, in venepuncture, a simple common invasive clinical procedure, preventing errors is paramount to assure not only the quality of the blood sample but also to prevent harm to staff and patients. This paper illustrates how modelling medical procedures using reliability analysis techniques of engineering systems can potentially improve healthcare safety and efficiency.

Methodology This study investigates the current standards in venepuncture pertinent to Phlebotomists and junior doctors. A simulation-based methodology is developed to represent and analyse this medical procedure, by producing a mathematical model with graphical and probabilistic modelling features. The modelling framework consists of a number of modules, such as data collection and analysis, simulation, resource availability and optimisation and critical analysis.

Outcomes The mathematical model aims to demonstrates how any deviations from the guidelines affect the outcome of the process, for example, reliability and duration of the process, patient outcomes and staff cost. We hypothesise that the most advantageous allocation of resources and the most critical factors of the process can be identified. Our results might support the introduction of solutions for increased patient safety and healthcare efficiency by identifying the area of focus for quality improvements, demonstrate the effects of future investments and formulate and enforce guidelines.

Conclusions and recommendations In addition to the advances proposed in the reliability modelling technique for healthcare systems and transfer of knowledge between healthcare and engineering, this paper is based on direct observation of venepuncture within secondary healthcare. This approach advances academic understanding in healthcare modelling, that can benefit staff, managers and policy makers but most importantly patients themselves.


  1. Nolan T, Resar R, Haraden C, Griffin FA. Improving the Reliability of Health Care. IHI Innovation Series white paper. Boston: Institute for Healthcare Improvement; 2004

  2. World Health Organisation. 2010. WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy. Geneva. WHO Library Cataloguing-in-Publication Data

  3. Bayer S. 2014. Simulation Modelling and Resource Allocation in Complex Services. BMJ Quality and Safety. published online 2014

  4. Lofstrand M, Reed S, Karlberg M, et al. Modelling and Simulation of Functional Product System Availability and Support Costs. International Journal of Product Development 2012;16:304–325

  • Category: Course or curriculum evaluation/innovation/integration

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.