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Emergency and on-demand health care: modelling a large complex system

Emergency and on-demand health care: modelling a large complex system
Emergency and on-demand health care: modelling a large complex system
This paper describes how system dynamics was used as a central part of a whole-system review of emergency and on-demand health care in Nottingham, England. Based on interviews with 30 key individuals across health and social care, a 'conceptual map' of the system was developed, showing potential patient pathways through the system. This was used to construct a stock-flow model, populated with current activity data, in order to simulate patient flows and to identify system bottle-necks. Without intervention, assuming current trends continue, Nottingham hospitals are unlikely to reach elective admission targets or achieve the government target of 82% bed occupancy. Admissions from general practice had the greatest influence on occupancy rates. Preventing a small number of emergency admissions in elderly patients showed a substantial effect, reducing bed occupancy by 1% per annum over 5 years. Modelling indicated a range of undesirable outcomes associated with continued growth in demand for emergency care, but also considerable potential to intervene to alleviate these problems, in particular by increasing the care options available in the community.
emergency and on-demand health care, A&E, simulation, system dynamics, discrete event simulation, modelling
0160-5682
34-42
Brailsford, S.C.
634585ff-c828-46ca-b33d-7ac017dda04f
Lattimer, V.A.
5aa2c9a5-13cb-4776-9b0d-c618e6913f5b
Tarnaras, P.
9e37111e-ad77-4dff-af3d-04413d9ba696
Turnbull, J.C.
cd1f8462-d698-4a90-af82-46c39536694b
Brailsford, S.C.
634585ff-c828-46ca-b33d-7ac017dda04f
Lattimer, V.A.
5aa2c9a5-13cb-4776-9b0d-c618e6913f5b
Tarnaras, P.
9e37111e-ad77-4dff-af3d-04413d9ba696
Turnbull, J.C.
cd1f8462-d698-4a90-af82-46c39536694b

Brailsford, S.C., Lattimer, V.A., Tarnaras, P. and Turnbull, J.C. (2004) Emergency and on-demand health care: modelling a large complex system. Journal of the Operational Research Society, 55 (1), 34-42. (doi:10.1057/palgrave.jors.2601667).

Record type: Article

Abstract

This paper describes how system dynamics was used as a central part of a whole-system review of emergency and on-demand health care in Nottingham, England. Based on interviews with 30 key individuals across health and social care, a 'conceptual map' of the system was developed, showing potential patient pathways through the system. This was used to construct a stock-flow model, populated with current activity data, in order to simulate patient flows and to identify system bottle-necks. Without intervention, assuming current trends continue, Nottingham hospitals are unlikely to reach elective admission targets or achieve the government target of 82% bed occupancy. Admissions from general practice had the greatest influence on occupancy rates. Preventing a small number of emergency admissions in elderly patients showed a substantial effect, reducing bed occupancy by 1% per annum over 5 years. Modelling indicated a range of undesirable outcomes associated with continued growth in demand for emergency care, but also considerable potential to intervene to alleviate these problems, in particular by increasing the care options available in the community.

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Latter,_V_&_Turnbull,_J._et_al_-_emergency_report_-_Jrnal_-_2004.pdf - Other
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More information

Published date: January 2004
Keywords: emergency and on-demand health care, A&E, simulation, system dynamics, discrete event simulation, modelling

Identifiers

Local EPrints ID: 9600
URI: https://eprints.soton.ac.uk/id/eprint/9600
ISSN: 0160-5682
PURE UUID: bca866c6-30c3-43a9-929e-7ad5e0e5f8c8
ORCID for S.C. Brailsford: ORCID iD orcid.org/0000-0002-6665-8230
ORCID for J.C. Turnbull: ORCID iD orcid.org/0000-0002-5006-4438

Catalogue record

Date deposited: 24 May 2006
Last modified: 01 Dec 2018 01:36

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Contributors

Author: S.C. Brailsford ORCID iD
Author: V.A. Lattimer
Author: P. Tarnaras
Author: J.C. Turnbull ORCID iD

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