How can operational research make a real difference in healthcare? Challenges of implementation

Carter, Michael; Busby, Carolyn R.

doi:10.1016/j.ejor.2022.04.022

Cited by 9 publications

(3 citation statements)

References 44 publications

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“…Participants in PSM workshops develop procedures jointly by participating in interactive conversations as part of a workshop setting. These approaches ensure that decision-making and negotiation processes are informed about the problem's nature, potential solutions, and actions that can be taken to solve it [28]; yet, meanwhile, they will most likely not produce exact quantitative solutions [29]. Accordingly, in many cases, PSMs have been criticized [30].…”

Section: Introductionmentioning

confidence: 99%

Solving the Problem of Reducing the Audiences’ Favor toward an Educational Institution by Using a Combination of Hard and Soft Operations Research Approaches

Xu,

Edalatpanah,

Sorourkhah

2023

Mathematics

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Because of hyper-complexity, a difficulty to define, multiple stakeholders with conflicting perspectives, and a lack of clear-cut solutions, wicked problems necessitate innovative and adaptive strategies. Operations research (OR) has been a valuable tool for managers to make informed decisions for years. However, as we face increasingly complex and messy problems, it has become apparent that relying solely on either hard or soft OR approaches is no longer sufficient. We need to explore more innovative methodologies to address these wicked problems effectively. This study has bridged the research gap by proposing a structured process encompassing a subdivision-based problem structuring method for defining the wicked problem, a multi-attribute decision-making (MADM) for prioritizing subproblems, and a hard OR technique, data envelopment analysis (DEA) for tackling one of the most critical subdivisions. The proposed methodology, the subdivision-based problem structuring method (SPSM), implemented in a case study, focuses on a higher education institution experiencing a decline in student admissions and involves five steps. First, a diverse group of stakeholders is formed to ensure the comprehensive consideration of perspectives. Second, the wicked problem is defined, considering long-term consequences, multiple stakeholders, and qualitative stakeholder opinions. Third, a hierarchical structure is created to break down the wicked problem into manageable subproblems. Fourth, a multi-criteria decision-making (MCDM) method prioritizes subproblems. Finally, the subproblems are addressed one by one using a combination of soft and hard OR tools. The findings highlight the benefits of integrating hard and soft OR approaches. The study concludes with reflections on the implications of using a combined OR approach to tackle wicked problems in higher education and beyond.

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Section: Introductionmentioning

confidence: 99%

Solving the Problem of Reducing the Audiences’ Favor toward an Educational Institution by Using a Combination of Hard and Soft Operations Research Approaches

Xu,

Edalatpanah,

Sorourkhah

2023

Mathematics

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“…Operations research (OR) is a scientific approach to improved decision-making, where complex systems and processes are analyzed and optimized using mathematical modeling, statistics, and other tools and technologies. OR methodologies have been widely applied to healthcare problems [12,13,14,15], but there is not much evidence of successful implementation in clinical practice [16,17]. The RT scheduling problem has been modeled using OR in several studies, for a selection see [18,19,20,21,22,23].…”

mentioning

confidence: 99%

Automated Radiation Therapy Patient Scheduling: A Case Study at a Belgian Hospital

Frimodig¹,

Mercier²,

Kerf³

2023

Preprint

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The predicted increase in the number of patients receiving radiation therapy (RT) to treat cancer calls for an optimized use of resources. To manually schedule patients on the linear accelerators delivering RT is a time-consuming and challenging task. Operations research (OR), a discipline in applied mathematics, uses a variety of analytical methods to improve decision-making. In this paper, we study the implementation of an OR method that automatically generates RT patient schedules at an RT center with ten linear accelerators. The OR method is designed to produce schedules that mimic the objectives used in the clinical scheduling while following the medical and technical constraints. The resulting schedules are clinically validated and compared to manually constructed, historical schedules for a time period of one year. It is shown that the use of OR to generate schedules decreases the average patient waiting time by 80%, improves the consistency in treatment times between appointments by 80%, and increases the number of treatments scheduled the machine best suited for the treatment by more than 90% compared to the manually constructed clinical schedules, without loss of performance in other quality metrics. Furthermore, automatically creating patient schedules can save the clinic many hours of administrative work every week.

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“…Simulation modelling has been widely used in healthcare applications since the 1960s, both by academics and by commercial business consultancies. However, despite a plethora of survey papers over the decades (Tunnicliffe Wilson, 1 Lagergren, 2 Fone et al, 3 Brailsford et al, 4 Tako and Robinson, 5 Darabi and Hosseinichimeh, 6 Carter and Busby 7 to name but a few) there is scant evidence in the literature of such models having much impact on practice. The figure of 5% for ‘implemented’ system dynamics (SD) models cited by Holmström et al 8 derives from Brailsford et al 4 and refers to journal articles that state that the model findings are being used by a healthcare organisation.…”

mentioning

confidence: 99%

Closing the Implementation Gap Comment on "Insights Gained From a Re-analysis of Five Improvement Cases in Healthcare Integrating System Dynamics Into Action Research"

Brailsford

2022

Int J Health Policy Manag

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Holmström et al. provide an interesting and thought-provoking contribution to a perennial problem: why, despite a vast number of applications of simulation modelling in healthcare over the past 70 years, there is still remarkably little evidence of successful implementation of model results. Their paper is a retrospective analysis of five case studies, all undertaken as consultancy, that used a blend of system dynamics modelling and action research. This commentary assesses the effectiveness of this approach in achieving implementation, based on the evidence presented, and discusses some of the issues raised. These issues include a comparison of Holmström’s approach with group model building in system dynamics, the differences between healthcare modelling projects undertaken by a) business consultants and b) academics, and the challenges of undertaking ‘systematic’ reviews of the grey literature.

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How can operational research make a real difference in healthcare? Challenges of implementation

Cited by 9 publications

References 44 publications

Solving the Problem of Reducing the Audiences’ Favor toward an Educational Institution by Using a Combination of Hard and Soft Operations Research Approaches

Solving the Problem of Reducing the Audiences’ Favor toward an Educational Institution by Using a Combination of Hard and Soft Operations Research Approaches

Automated Radiation Therapy Patient Scheduling: A Case Study at a Belgian Hospital

Closing the Implementation Gap Comment on "Insights Gained From a Re-analysis of Five Improvement Cases in Healthcare Integrating System Dynamics Into Action Research"

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