A simulation-based modeling framework to deal with Clinical Pathways

Özcan, Yaşar A.; Tànfani, Elena; Testi, Angela

doi:10.1109/wsc.2011.6147841

Cited by 18 publications

(13 citation statements)

References 14 publications

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“…Obtained Data Driven [5, 7-9, 11, 13, 32, 33, 37, 47-49, 54, 58, 62, 66, 70-72, 74-76, 80, 81, 83, 85-99, 104, 107, 108, 112, 120, 121, 124, 126, 127, 131, 133, 134, 138-140, 143, 144, 147-150, 153, 157, 160, 162, 167, 170, 172, 177-179, 183-185, 191, 192, 195, 197-206, 209-211] Collaboration [3,10,14,17,27,42,51,73,100,114,142,152,163] Both [12,20,35,40,56,101,103,129,136,146,154,166,171,186] Other [19,21,22,24,41,60,79,82,116,128,169] Table A6. Care level considered.…”

Section: Fundingmentioning

confidence: 99%

Clinical pathway modelling: a literature review

2019

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Hospital information systems are increasingly used as part of decision support tools for planning at strategic, tactical and operational decision levels. Clinical pathways are an effective and efficient approach in standardising the progression of treatment, to support patient care and facilitate clinical decision making. This literature review proposes a taxonomy of problems related to clinical pathways and explores the intersection between Information Systems (IS), Operational Research (OR) and industrial engineering. A structured search identified 175 papers included in the taxonomy and analysed in this review. The findings suggest that future work should consider industrial engineering integrated with OR techniques, with an aim to improving the handling of multiple scopes within one model, while encouraging interaction between the disjoint care levels and with a more direct focus on patient outcomes. Achieving this would continue to bridge the gap between OR, IS and industrial engineering, for clinical pathways to aid decision support.

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Section: Fundingmentioning

confidence: 99%

Clinical pathway modelling: a literature review

2019

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“…Given the parameters presented in Tables 2 and 3, we will deploy simulation-optimization approach as a main component of a more comprehensive performance assessment and management framework for analyzing clinical pathways [33,34]. In this study, we apply the simulation-optimization approach to model a real case, namely to evaluate the thyroid surgical treatment together with the other surgery-based CPs.…”

Section: Simulation-optimization Modelling Approachmentioning

confidence: 99%

“…In Section 3.1, the prototype simulation model proposed in Ozcan et al [33] has been revised and fine-tuned to represent the operative scenario of the Department under study and the observed patient flows. In Section 3.2, the model has been fine-tuned and validated with the new data collected in the present case study.…”

Section: Simulation-optimization Modelling Approachmentioning

confidence: 99%

“…The simulation-optimization modelling approach has been applied to study the thyroid surgical clinical pathway, which is the main diagnosis on discharge in the presented case study and has already been investigated in previous papers [11,33,34]. Moreover, thyroid surgical treatment fits the selection criteria outlined in Zander [9] in order to select a disease that lends itself to standardized flow management.…”

Section: Introduction and Aim Of The Studymentioning

confidence: 99%

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Improving the performance of surgery-based clinical pathways: a simulation-optimization approach

Özcan

Tànfani

Testi

2016

Health Care Manag Sci

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This paper aims to improve the performance of clinical processes using clinical pathways (CPs). The specific goal of this research is to develop a decision support tool, based on a simulation-optimization approach, which identify the proper adjustment and alignment of resources to achieve better performance for both the patients and the health-care facility. When multiple perspectives are present in a decision problem, critical issues arise and often require the balancing of goals. In our approach, meeting patients' clinical needs in a timely manner, and to avoid worsening of clinical conditions, we assess the level of appropriate resources. The simulation-optimization model seeks and evaluates alternative resource configurations aimed at balancing the two main objectives-meeting patient needs and optimal utilization of beds and operating rooms.Using primary data collected at a Department of Surgery of a public hospital located in Genoa, Italy. The simulation-optimization modelling approach in this study has been applied to evaluate the thyroid surgical treatment together with the other surgery-based CPs. The low rate of bed utilization and the long elective waiting lists of the specialty under study indicates that the wards were oversized while the operating room capacity was the bottleneck of the system. The model enables hospital managers determine which objective has to be given priority, as well as the corresponding opportunity costs.

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“…Because all practical aspects of the hospital cannot be simulated, it is important to incorporate institutional knowledge at the highest possible level to decide what aspects to include in the development of the simulation model. 32,33 The goal was to understand the magnitude of change that could be expected if these scenarios were implemented in the actual hospital. The model was constructed using the Promodel simulation software.…”

Section: Validation Using Simulationmentioning

confidence: 99%

A Framework for Improving Access and Customer Service Times in Health Care

Duda

Rajaram

Barz

et al. 2013

The Health Care Manager

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There has been an increasing emphasis on health care efficiency and costs and on improving quality in health care settings such as hospitals or clinics. However, there has not been sufficient work on methods of improving access and customer service times in health care settings. The study develops a framework for improving access and customer service time for health care settings. In the framework, the operational concept of the bottleneck is synthesized with queuing theory to improve access and reduce customer service times without reduction in clinical quality. The framework is applied at the Ronald Reagan UCLA Medical Center to determine the drivers for access and customer service times and then provides guidelines on how to improve these drivers. Validation using simulation techniques shows significant potential for reducing customer service times and increasing access at this institution. Finally, the study provides several practice implications that could be used to improve access and customer service times without reduction in clinical quality across a range of health care settings from large hospitals to small community clinics.

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A simulation-based modeling framework to deal with Clinical Pathways

Cited by 18 publications

References 14 publications

Clinical pathway modelling: a literature review

Clinical pathway modelling: a literature review

Improving the performance of surgery-based clinical pathways: a simulation-optimization approach

A Framework for Improving Access and Customer Service Times in Health Care

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