Download ppt - System Dynamics for Strategic Resource Planning at Watford Hospital Esther Moors Goncalo Esteves 13/11/2013

System Dynamics for Strategic Resource Planning at Watford Hospital

Esther Moors

Goncalo Esteves

13/11/2013


PeopleDavid Gaunt Esther MoorsRuth ConnollyKim WarrenGonçalo Esteves Douglas McKelvie


MotivationsTo have science behind “gut feeling” and experience of A&E professionalsto ensure the intended results in the long term

David GauntEsther MoorsRuth Connolly August 2013


VisionThe vision of future work is that the modelling methodologies should be integrated into the everyday activities of the clinicians and staff that deal with changes to the emergency medical pathway,

after this is achieved…

simulating changes before implementing them should become a part of the Trust management processes.


Project Requirements – what to achieve?•1. A simulation environment to test policies, processes and decisions regarding the planning, deployment and maintenance of resources in emergency medical pathways at Watford Hospital.•2. A simulation toolkit enabling the sponsors to simulate decision making in emergency medical care.•3. A training environment for the internal use on A&E specific to the System Dynamics simulation tool, with supporting elective materials.•4. Use case for the Master Thesis of Goncalo Esteves.


Project Requirements – questions to be answered with the SD model:

1.What is the impact of increasing A&E flow direct to Medical Wards?

2.What is the impact of increasing the flow of patients from A&E to Ambulatory Care?

3.What happens if we have if we have more frail elderly patients going to ambulatory care, as opposed to being admitted?

4.When to change medical staffing arrangements?

5.Which are the most valuable staff arrangements to do?

6.What type of bed allocation is more effective?

7.What can cause the patient flow to stop?

8.What is the best use of beds over time?

9.What is the effect of having a GP in the initial assessment?

10. What is or what would be a single pathway of patients in the A&E?


Project Requirements – questions to be answered with the SD model:

1 – What is the impact of increasing A&EtoMedW

Bed numbers ( less beds available, more beds, less duration in stay, better care…)

2 – what is the impact of increasing the flow of patients from A&E to Ambulatory Care

Bed numbers ( less beds, more beds, less duration, better care)


Project Planning

Phase I – A&E Modelling ( Physical Flows of Patients)September- November 2013

Phase II – A&E Modelling Strategic Resource PlanningNovember- December 2013

Phase III – A&E Simulation use for Training and Decision Making December- January 2014

System Dynamics for Strategic Resource Planning at Watford A&E

Current State


Current State


Future StepsModel Validation Phase I-Data reality checks-Model limitationsModelling Resource Planning-Beds-Medical Staff-Facilities Personal-Other Physical assets


Future StepsModel Validation Phase I-Data reality checks-Model limitationsModelling Resource Planning-Beds-Medical Staff-Facilities Personal-Other Physical assets


Future StepsModelling Available to Available – a function that includes critical factors in the achievement of A&E GoalsInfluence of:1.Number of bed changes2.Age of patients3.Number of patients4.Day of week5.Consultants


Future StepsModelling Available to Available – a function that includes critical factors in the achievement of A&E Goals


Future StepsTrainingA&E Decision Makers – to ensure


Lessons Learned so far:

Access to data has many stepsModel validation to be done in terms of parts and not the wholeKeep modelling simple A4 – A3 pageImpact of factors outside our direct control – eg changes in staffing


Achievements:•Common Framework for A&E ( Phase I)•Complexity decrease in model•Single source of data and QA process•Continuous support of the SD modelling approach by Watford•Specific questions (requirements) definition


Q/A


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