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Why is Simulation Modelling Needed?

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Why is Simulation Modelling Needed?

"A well designed Simulation Model can help you to garner consensus & generate confidence as you design 'tried & tested' improvements that have never been done before."

A System view of Healthcare would show it to have:

·         High levels of Complexity

·         Multiple Inter-dependencies

·         Lots of Variation in Demand & Delivery

·         Severe Competition for & Rationing of Resources.

Stochastic simulation models (cf. ‘deterministic’ models) allow you to introduce Randomness and Patient-related Probabilities and so make your Simulation Model more realistic. After all, Patients are individual People and we respond differently to Treatment, our Emotional or Psychological needs can impact our behaviour, and our Social circumstances can extend our Length of Stay in a Service.

This way, we can avoid using “Averages” as constants – if we use them in a system where Arrivals are not at fixed regular intervals (e.g. Emergency Referrals) and where we have high levels of Resource Utilisation (e.g. +95% Bed Occupancy) and we see variable Service Times (e.g. Lengths of Stay), then the only certainty will be that our conclusion about required Capacity will be sub-Optimal. Indeed, Brent Wherry described using Averages in these circumstances as the “work of the devil”.

Computerised simulation models can provide visually powerful tools that can easily process many complex, inter-dependent decisions and so quickly provide the User with the likely consequences of a given Scenario. Often, a User will gain significant insight and greater understanding of their problem from the very process of Model Design in addition to the Execution of Scenarios and the Analysis of Outcomes. It is sometimes possible to design Simulation Models to find the Optimal Solution with a high level of Confidence – automatically!

Steven Burnell advises (all rights reserved) that Simulation Modelling can help you to:

·         Distil your Thoughts – Articulate the Problem clearly

·         See the Dynamics & Gain new Insights

·         Document your required Process Improvements

·         Collaborate & Eliminate duplication, gaps, & flaws

·         Develop Strategy, Management Plans, & Actions

·         Examine Strategic Choices – “See What Might Be”

·         Optimise your most valuable Resources.

“Simulation Models can help the User to make better informed, evidence-based Investment Choices and Resource Allocation Decisions.”

Dr Chris Manning: “We need to move towards services that are intelligent by virtue of the evidence and collaborative thought given to their design as well as informed by patient experiences and the outcomes and ‘results’ that matter to them.”

Lesley Callow, “It would definitely help the development of joint working across health and social care but keep the patient outcome central to the process. The tool could be utilised for all LTC’s. It would enable a sense of ownership from the bottom up (engaging clinicians and local leaders) and would be a valuable way of undertaking simulations that explore all the potential scenarios for future service delivery based on real data provided from the grass roots with an embedded robust evidence base underpinning the modelling without the need to change any service and directly affect patient care unless it was clear that it improved outcomes.”  (Lesley’s personal views not to be taken as an endorsement by DH or QIPP Program)

In short:

If a change is simple, low risk, easily reversed, and at no great cost, then just “Think & Do!”

But, when it comes to Strategic Thinking or Service Re-design “If you can’t Model it, you can’t Achieve it.”


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