The SIMTEGR8 project adapted the SimLean approach for the analysis of four interventions. The aims of the methodology were to generate discussion about the model, the patient pathway, the reality of the situation and the veracity of the metrics being gathered as evaluations of the patient pathway; and to Identify and resolve issues in order to improve the efficiency and effectiveness of the pathway with focus on good patient care.
The evaluation of the pathway started with gathering data about the patient pathway. This can be done in collaboration with the local authority and the staff working with the service being examined.
The data are interpreted as a process map, a diagram of the way that the patient travels through the system. The process map is then used to produce an approximate computer simulation model of the system; not detailed or perfect but good enough to show the basic process at work. The computer simulation produced can then be used as a dynamic process map to focus discussion about the patient pathway in a workshop of invited participants.
A set of specific steps are proposed then to be followed in the workshop. There are two forms that can be used, depending on the nature of the participants. For a workshop of health practitioners there are four steps as follows:
Model Understanding – Present a “Before” and “After” process map of each intervention to verify whether it is a reasonable depiction of the patient pathway and that participants understand the concept of simulation modelling
Face Validation – The approximate model is run to illustrate the agreed process. This is used as a the basis of a discussion of whether the model represents what happens in reality
Problem Scoping – The discussion them moves on to issues that have been revealed by running the model
Improvements – Finally ways of resolving the issues are offered by participants
If the participants are users of the patient pathway the steps follow a similar pattern but with a greater input of patient experience, as can be seen below:
Model Understanding – The intervention is described to the participants, the model is explained and the simulation run showing the movement of patients around the system
Problem Scoping – The discussion them moves on to issues that have been revealed by running the model and the participants own issues and concerns
Improvements – The discussion turns to methods of improving the pathway and finding ways of measuring patient satisfaction