Models of evaluation under ceteris imparibus: System dynamics and the example of emergency care

McAvoy, Susan; Staib, Andrew; Birch, Stephen

doi:10.1002/sres.2615

Cited by 2 publications

(2 citation statements)

References 36 publications

(94 reference statements)

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“…This may have caused serious obstacles in the implementation process. Such issues can be expressed in terms of upcoming confounding factors that need to be accounted for [44]. We can only speculate that implementation during the rst year of the COVID-19 pandemic is a source of the negative attitudes of ED2.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the implementation process of a new emergency triage system, WEst coast System for Triage (WEST)

Habbouche,

Carlström,

Magnusson

et al. 2024

Preprint

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Background: The global escalation of Emergency Department (ED) crowding has prompted the development of innovative solutions to alleviate strain and enhance patient prioritization. One such solution is the WEst coast System for Triage (WEST), based on the South African Triage Scale. Initially Introduced at Sahlgrenska University Hospital in Western Sweden between 2019 and 2021, WEST has since been adopted by numerous hospital EDs in the region, replacing the established Rapid Emergency Triage and Treatment System (RETTS©). Despite WEST's apparent success in enhancing patient flow and prioritization, reports suggest that challenges arose during its implementation. Previous descriptions highlight how subcultures within hospital organizations impede new working methods. This study aims to map the implementation process at the initial two EDs adopting WEST and identify hindrances. We focus on the transition from RETTS© to WEST, studying staff experiences during various implementation stages. Method: Thirty-six triage nurses from two hospitals participated in semi-structured individual interviews, offering insights into their experiences with WEST, challenges faced, and a comparison with RETTS©. The first hospital, ED1, initiated the process earlier than ED2. Roger's diffusion of innovations model guided the deductive analysis, supplemented by quantitative analysis using Likert scales. Results: Out of the interviewees, 17 were from ED1 and 19 from ED2. ED1 exhibited enthusiasm and perceived WEST as a significant improvement in triage. Conversely, ED2's responses were varied, with some expressing reservations about the implementation process and the new system. Based on Roger's model, ED1 could be categorized as early adopters, while ED2 represented a mix of early and late majority. Despite varying responses, most participants (30 out of 36) agreed on WEST's enhanced accuracy in identifying critically ill patients during triage compared to RETTS© Conclusion The implementation of WEST faced challenges in both EDs, with ED1 displaying more enthusiasm compared to ED2. However, the majority recognized WEST's effectiveness in prioritizing patients accurately. This study sheds light on the dynamics of implementing new triage systems and underscores the importance of understanding and addressing challenges during the process.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the implementation process of a new emergency triage system, WEst coast System for Triage (WEST)

Habbouche,

Carlström,

Magnusson

et al. 2024

Preprint

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“…Implementation of SD models, ceteris paribus, to evaluate emergency care was presented in [187]. According to the authors, a SD approach offers significant advantages over more traditional modeling tools, as this approach can effectively incorporate dynamic and organizational complexity in today's heavily interconnected and interdependent healthcare systems.…”

Section: Health Care and Related Areasmentioning

confidence: 99%

Environment, Business, and Health Care Prevail: A Comprehensive, Systematic Review of System Dynamics Application Domains

Zanker

Bureš

Tučník

2021

Systems

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System dynamics, as a methodology for analyzing and understanding various types of systems, has been applied in research for several decades. We undertook a review to identify the latest application domains and map the realm of system dynamics. The systematic review was conducted according to the PRISMA methodology. We analyzed and categorized 212 articles and found that the vast majority of studies belong to the fields of business administration, health, and environmental research. Altogether, 20 groups of modeling and simulation topics can be recognized. System dynamics is occasionally supported by other modeling methodologies such as the agent-based modeling approach. There are issues related to published studies mostly associated with testing of validity and reasonability of models, leading to the development of predictions that are not grounded in verified models. This study contributes to the development of system dynamics as a methodology that can offer new ideas, highlight limitations, or provide analogies for further research in various research disciplines.

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Models of evaluation under ceteris imparibus: System dynamics and the example of emergency care

Cited by 2 publications

References 36 publications

Evaluation of the implementation process of a new emergency triage system, WEst coast System for Triage (WEST)

Evaluation of the implementation process of a new emergency triage system, WEst coast System for Triage (WEST)

Environment, Business, and Health Care Prevail: A Comprehensive, Systematic Review of System Dynamics Application Domains

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