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Evaluating the impact of a simulation study in emergency stroke care

Evaluating the impact of a simulation study in emergency stroke care
Evaluating the impact of a simulation study in emergency stroke care
Very few discrete-event simulation studies follow up on recommendations with evaluation of whether modelled benefits have been realised and the extent to which modelling contributed to any change. This paper evaluates changes made to the emergency stroke care pathway at a UK hospital informed by a simulation modelling study. The aims of the study were to increase the proportion of people with strokes that undergo a time-sensitive treatment to breakdown a blood clot within the brain and decrease the time to treatment. Evaluation involved analysis of stroke treatment pre- and post- implementation, as well as a comparison of how the research team believed the intervention would aid implementation compared to what actually happened. Two years after the care pathway was changed, treatment rates had increased in line with expectations and the hospital was treating four times as many patients than before the intervention in half the time. There is evidence that the modelling process aided implementation, but not always in line with expectations of the research team. Despite user involvement throughout the study it proved difficult to involve a representative group of clinical stakeholders in conceptual modelling and this affected model credibility. The research team also found batch experimentation more useful than visual interactive simulation to structure debate and decision making. In particular, simple charts of results focused debates on the clinical effectiveness of drugs - an emergent barrier to change. Visual interactive simulation proved more useful for engaging different hospitals and initiating new projects.
40-49
Monks, Thomas
fece343c-106d-461d-a1dd-71c1772627ca
Pearson, M.
09c6ad3c-563f-4b64-acf4-f1587ccfcbfc
Pitt, M.
ee0d6a9d-e552-49ce-9351-b4de8d3923d1
Stein, K.
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James, M.
f49adb0e-798c-4854-854d-cfd3364d9623
Monks, Thomas
fece343c-106d-461d-a1dd-71c1772627ca
Pearson, M.
09c6ad3c-563f-4b64-acf4-f1587ccfcbfc
Pitt, M.
ee0d6a9d-e552-49ce-9351-b4de8d3923d1
Stein, K.
5f0b93b6-a47b-4976-b813-f498931d5286
James, M.
f49adb0e-798c-4854-854d-cfd3364d9623

Monks, Thomas, Pearson, M. and Pitt, M. et al. (2015) Evaluating the impact of a simulation study in emergency stroke care. Operations Research for Health Care, 6, 40-49. (doi:10.1016/j.orhc.2015.09.002).

Record type: Article

Abstract

Very few discrete-event simulation studies follow up on recommendations with evaluation of whether modelled benefits have been realised and the extent to which modelling contributed to any change. This paper evaluates changes made to the emergency stroke care pathway at a UK hospital informed by a simulation modelling study. The aims of the study were to increase the proportion of people with strokes that undergo a time-sensitive treatment to breakdown a blood clot within the brain and decrease the time to treatment. Evaluation involved analysis of stroke treatment pre- and post- implementation, as well as a comparison of how the research team believed the intervention would aid implementation compared to what actually happened. Two years after the care pathway was changed, treatment rates had increased in line with expectations and the hospital was treating four times as many patients than before the intervention in half the time. There is evidence that the modelling process aided implementation, but not always in line with expectations of the research team. Despite user involvement throughout the study it proved difficult to involve a representative group of clinical stakeholders in conceptual modelling and this affected model credibility. The research team also found batch experimentation more useful than visual interactive simulation to structure debate and decision making. In particular, simple charts of results focused debates on the clinical effectiveness of drugs - an emergent barrier to change. Visual interactive simulation proved more useful for engaging different hospitals and initiating new projects.

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More information

Accepted/In Press date: 6 September 2015
e-pub ahead of print date: 16 September 2015
Published date: 16 September 2015
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 373229
URI: http://eprints.soton.ac.uk/id/eprint/373229
PURE UUID: 75b4ccbe-23b4-4a53-b96d-47933afbf04f
ORCID for Thomas Monks: ORCID iD orcid.org/0000-0003-2631-4481

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Date deposited: 13 Jan 2015 11:33
Last modified: 14 Mar 2024 18:50

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Contributors

Author: Thomas Monks ORCID iD
Author: M. Pearson
Author: M. Pitt
Author: K. Stein
Author: M. James

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