Three critical challenges for modeling and simulation in healthcare

Abstract

By most measures, the adoption of modeling and simulation techniques in healthcare service development falls well short of the uptake of such techniques evident in other sectors, such as business and commerce or aerospace and the military. The question is, why? To answer this, we consider three questions and then turn to the nature of answer which might lead towards greater adoption. The first is the vexed question of how good is good enough? The second concerns how best modeling should link through to decision-making; and the third concerns the culture needed to make the most of modeling and simulation (and whether it is worth the effort to make the transformation). From these, we draw an agenda for further enquiry in terms of stakeholders, their culture, data, and expectations, and the case in terms of value.

SimLean: Utilising simulation in the implementation of lean in healthcare

“…These benefits can easily be translated to other contexts such as services and healthcare. The actual implementation of DES in healthcare may not be so straightforward with authors positing a range of reasons why implementing DES in healthcare is more problematic than in other domains (Brailsford, 2005;Kuljis et al, 2007;Eldabi, 2009;Young et al, 2009). Two key differences that are stated in relation to the stakeholders are: the difficulty of engaging them in DES studies, and the problem of managing the conflicting interests of multiple stakeholders (Brailsford et al, 2009b;Eldabi, 2009).…”

“…As for manufacturing, simulation promises many benefits for health applications including risk reduction for changes to processes, cost and lead time reduction, increased customer satisfaction and greater understanding of healthcare processes among their stakeholders (Hollocks, 1992). However, these benefits are not necessarily being achieved with much evidence to suggest that simulation is simply not having the impact it could in the health sector (Young et al, 2009). …”

Is simulation in health different?

“…patients, physicians, nurses) whose interactions do not result in the simple production of a final product, 'health'. Harper and Pitt (2004) and Brailsford et al (2009) discuss the complexity that arises from the interconnectivity of healthcare systems and Young et al (2009) point to the scale of healthcare systems as a source of complexity.…”

A generic method to develop simulation models for ambulance systems

“…This is driven by such factors as the increasing and aging population, especially in urban centres [29,30] with a knock-on effect for ambulance services. Comparisons with manufacturing and military usage have revealed a significant lack impact for healthcare modelling [31,32], and there has been a discussion of the barriers faced in healthcare [33,34].…”

“…Young et al [34] have suggested the use of generic models as a strategy to improve the adoption of OR techniques in healthcare, enabling service managers to set up models or reuse them in analysing their specific systems. This work is consonant with earlier findings.…”