An Agenda for Healthcare and Information Simulation

Abstract

With healthcare systems around the world undergoing redesign and refocusing on patients, there is a strategic role that simulation modellers could play. The creation of strategic scenarios that work according to process philosophies--as used, for instance, in manufacturing--could help to deliver high quality care to millions of people. There may, in addition, be serendipitous synergies between some of these industrial process philosophies and known simulation techniques. This paper addresses some strategic issues around the processes of care delivery, and considers the resultant research agenda. Not only is this strategic agenda one that would help care providers, but it is possible to derive some concepts that enable technology to be valued as part of care provision. The paper explores how, in general terms, value propositions may be derived that are acceptable to commissioning agencies and accessible to technology vendors. Were it possible to formalise these, they would be of significant benefit both to healthcare service providers and to their suppliers.

Using simulation modeling to improve patient flow at an outpatient orthopedic clinic

“…As simulation tools have improved and an emphasis on cost control and efficiency has become more important in health care, researchers continue to suggest its use. Ledlow & Bradshaw [11] point out the value of animation and visualization when applying simulation to health care settings, and Young [12] discusses how simulation can assist health care organizations explore alternative patient pathways with the "lean" methodology so many of them are adopting. Finally, in their evaluation of modeling methods for health care, Cooper, Brailsford, & Davies [13] note that simulation may be particularly useful where "queuing for resources, resource constraints or the interactions between individuals" are important.…”

OR and the challenge to improve the NHS: modelling for insight and improvement in in-patient flows

“…The MA has primarily been looking to operations management for guidance on system improvement (Walley, 2003;Young et al, 2004;Boaden et al, 2005;Young, 2005). This may be due in part to the influence of US approaches, were healthcare improvement is also dominated by operations management (eg Mango and Shapiro, 2001;Institute for Healthcare Improvement, 2003;Spear, 2005).…”

“…When the Labour government came to power in 1997, a series of teams was set up to transform various areas of the National Health Service (NHS), particularly through re-design of processes (Young, 2005) and, currently, through the way organizations are reimbursed for activity. The NHS Modernization Agency (MA) was established in 2001 to bring together much of this change-support work in England; Don Berwick (President and CEO of the US Institute for Healthcare Improvement, IHI) suggested this may have been the largest single-organization process improvement/re-engineering effort in history (NHS Modernisation Board, 2002).…”

Modeling patient service centers with simulation and system dynamics

“…System dynamics was identified by Young [10] as an appropriate method for improving healthcare management and was used in healthcare environments to explore policies for ongoing operations such as emergency departments [11,12]. Here, we describe a somewhat different use of system dynamics modeling.…”