A BPMN extension to support discrete-event simulation for healthcare applications: an explicit representation of queues, attributes and data-driven decision points

Abstract

Stakeholder engagement in simulation projects is important, especially in healthcare where there is a plurality of stakeholder opinions, objectives and power. One promising approach for increasing engagement is facilitated modelling. Currently, the complexity of producing a simulation model means that the 'model coding' stage is performed without the involvement of stakeholders, interrupting the possibility of a fully-facilitated project. Early work demonstrated that with currently-available software tools we can represent a simple healthcare process using Business Process Model and Notation (BPMN) and generate a simulation model automatically. However, for more complex processes, BPMN currently has a number of limitations, namely the ability to represent queues and data-driven decision points. To address these limitations, we propose a conceptual design for an extension to BPMN (BPMN4SIM) using Model Driven Architecture. Application to an elderly emergency care pathway in a UK hospital shows that BPMN4SIM is able to represent a more-complex business process.

Clinical pathway modelling: a literature review

“…Furthermore, six papers [3,14,24,151,164,202] discuss the use of 'Business Process Modeling Notation' (BPMN). BPMN is the use of graphical notation for the purpose of illustrating business processes.…”

“…JCR Category MI [3, 11, 13, 14, 16, 17, 19, 32, 37, 42, 45-47, 52, 54, 56, 57, 66, 72, 73, 1-93, 95-97, 99-101, 108, 122, 124, 131, 140, 144, 149, 150, 157, 160, 164, 170, 178, 187, 196, 197, 206, 211] OR/MS [7,8,12,18,22,23,27,30,31,43,50,51,64,75,79,90,113,114,134,151,158,165,169,190,203,212] HPS [9, 10, 21, 33, 39, 40, 80, 102-104, 110, 116, 141, 143, 153, 163, 166, 209] IE [34,120] AN [53,133] No ISSN [15,24,36,60,70,71,82,127,138,139,142,161,183,[198][199][200] Table A4. Way in which information about the pathway was obtained.…”

“…Scope Hospital [8, 21, 23, 27, 29-31, 36, 41, 51, 64, 67, 74-76, 79, 85, 108, 111, 114-117, 134, 142, 145-148, 152, 158, 160, 165, 166, 170, 177, 178, 184, 190, 202, 203, 209] Department [12,14,15,17,18,46,50,52,57,62,68,100,113,125,129,141,151,153,154,161,163,164,167,169,171,182,185,187,212] Clinical [1, 3, 5, 10, 11, 13, 16, 19, 20, 22, 32-35, 40, 42, 43, 45, 47, 53, 60, 70-73, 80-83, 87-99, 102, 107, 110, 112, 121, 124, 126-128, 133, 136, 139, 140, 149, 162, 179, 183, 186, 188, 191, 192, 195, 197-201, 204-206, 210, 211] Disease [4, 7, 9, 13, 24, 25, 37, 39, 43, 48, 49, 54-56, 58, 66, 86, 101-104, 118-120, 122, 128, 131, 138, 143, 144, 150, 157, 172, 196, 211] Table A5…”

“…Multiple Methods Two [8,11,12,18,54,74,76,99,108,140,151,162,167,179,190,203] Three [7,211] Table A11. Investigating type.…”

Evaluating Community-Based Integrated Health and Social Care Services: The Simtegr8 Approach

“…While the live development of models was possible for a simple model, this was not for more complex models. Further technological extensions to BPMN would be needed, to ensure that more complex models can be built jointly with stakeholders at workshops (Onggo et al 2018).…”