Overview
In this project we use a facilitated simulation modelling approach to support the development of patient centric integrated health and social care services aimed at reducing emergency hospital admission. The methodology carried out in this project is based on the SimLean Facilitate approach described in Robinson et al (2014) and the PartiSim approach described in Tako and Kotiadis (2015).
Simulation models are developed after discussing the pathways with relevant stakeholders in a facilitated workshop. These models are subsequently used in a facilitated workshop environment to generate understanding and discussion around the effectiveness of the pathway and how the user experience can be improved. Our focus is primarily in evaluating the services in order to make them more efficient and to improve the user experience.
A Conceptual Modelling workshop is carried out to discuss planned pathway of each intervention and reflect on its efficiency.
The discussion will go through the following phases:
- Aims of intervention: What aspect of the service should be evaluated?
- Draw process map: What are the main activities that take place in the real system?
- Pathway Effectiveness: What measures indicate success of the service? What works well? What doesn’t? What do users think of the service?
- Data Requirements: Who is responsible for providing the data required?
Having developed the conceptualised model, it is now time to move into the technical domain of coding this representation into the simulation software. This developmental process changes the Conceptual Model into the Computer Model.
Computer Simulation modelling uses mathematical data and algorithms to construct a virtual version of a system which can be run to visualise the system and to predict effects of changes in that system.
The principal advantage of simulation is that:
- It actually shows patients moving through the system. Here it is possible to witness the actual “flow” of the pathway.
- Stakeholders are able to see the effects of changes within a system in a simulated environment. In other words, there is no need for real-world trial and error and the associated costs and risks.
A workshop with Project Leads will be carried out using the model to facilitate discussion on each intervention and how it can be improved.
The discussion will go through the following phases:
- Model Understanding: What do you think the model is doing?
- Face Validation: Does this represent the real system?
- Problem Scoping: What is the impact of the intervention on ED admissions? Do we use the available resources effectively?
- Improvement: From your experience how could the impact of the intervention be improved?
A workshop with Patients and Carers is carried out using the model to facilitate discussion on how the service can be improved.
The discussion will go through the following phases:
- Model Understanding: What do you think the model is doing? Does this represent what the service felt like for you?
- Problem Scoping: Describe your experience of the pathway?
What do you think about the effectiveness of the pathways? - Improvement: What is needed to support frail and older people?
How should your experience be measured?