Towards fully-facilitated DES modelling:a successful project

The literature suggests that increasing stakeholder engagement in modelling has a positive impact on healthcare improvement projects using discrete-event simulation (DES). This suggests analysts should strive for the ‘fully-facilitated’ mode of simulation, meaning conducting the whole simulation project together with stakeholders. This paper investigates whether this might be possible in practice. This work arose from a research project with an Italian hospital. The paper describes a simulation project that succeeds in being fully-facilitated through all stages as far as the implementation stage, through combining Business Process Model and Notation (BPMN) and DES. We believe it is the first time that a fully-facilitated DES project in healthcare has been described

Using Strategic Options Development and Analysis (SODA) to Understand the Simulation Accessibility Problem

Simulation modelling is applied to a wide range of problems, including defense and healthcare. However, there is a concern within the simulation community that there is a limited use and implementation of simulation studies in practice. This suggests that despite its benefits, simulation may not be reaching its potential in making a real-world impact. The main reason for this could be that simulation tools are not widely accessible in industry. In this paper, we investigate the issues that affect simulation modelling accessibility through a workshop with simulation practitioners. We use Strategic Options Development and Analysis (SODA), a problem-structuring approach that allows for the stakeholder views to be expressed and linked in a systematic way. The causal map derived represents the emerging concepts and their effects, with the view to identifying their impact on the accessibility problem. We present our analysis of the issues and options identified. Based on our findings, we discuss the implications and recommendations for the future uptake of simulation

Application of Discrete-Event Simulation for Planning and Operations Issues in Mental Healthcare

Mental health disorders are on the rise around the world. Inadequate service provision and lack of access have led to wide gaps between the need for treatment and service delivery. Despite the popularity of Discrete-event Simulation (DES) in healthcare planning and operations, there is evidence of limited application of DES in planning for mental healthcare services. This paper identifies and reviews all the papers that utilize DES modelling to address planning and operations issues in mental healthcare services. The aim is to contribute a roadmap for the future application of DES in mental healthcare services, with an emphasis on planning and operations

ERP implementation methodologies and frameworks: a literature review

Enterprise Resource Planning (ERP) implementation is a complex and vibrant process, one that involves a combination of technological and organizational interactions. Often an ERP implementation project is the single largest IT project that an organization has ever launched and requires a mutual fit of system and organization. Also the concept of an ERP implementation supporting business processes across many different departments is not a generic, rigid and uniform concept and depends on variety of factors. As a result, the issues addressing the ERP implementation process have been one of the major concerns in industry. Therefore ERP implementation receives attention from practitioners and scholars and both, business as well as academic literature is abundant and not always very conclusive or coherent. However, research on ERP systems so far has been mainly focused on diffusion, use and impact issues. Less attention has been given to the methods used during the configuration and the implementation of ERP systems, even though they are commonly used in practice, they still remain largely unexplored and undocumented in Information Systems research. So, the academic relevance of this research is the contribution to the existing body of scientific knowledge. An annotated brief literature review is done in order to evaluate the current state of the existing academic literature. The purpose is to present a systematic overview of relevant ERP implementation methodologies and frameworks as a desire for achieving a better taxonomy of ERP implementation methodologies. This paper is useful to researchers who are interested in ERP implementation methodologies and frameworks. Results will serve as an input for a classification of the existing ERP implementation methodologies and frameworks. Also, this paper aims also at the professional ERP community involved in the process of ERP implementation by promoting a better understanding of ERP implementation methodologies and frameworks, its variety and history

Aligning systems science and community-based participatory research: A case example of the Community Health Advocacy and Research Alliance (CHARA).

Partnered research may help bridge the gap between research and practice. Community-based participatory research (CBPR) supports collaboration between scientific researchers and community members that is designed to improve capacity, enhance trust, and address health disparities. Systems science aims to understand the complex ways human-ecological coupled systems interact and apply knowledge to management practices. Although CBPR and systems science display complementary principles, only a few articles describe synergies between these 2 approaches. In this article, we explore opportunities to utilize concepts from systems science to understand the development, evolution, and sustainability of 1 CBPR partnership: The Community Health Advocacy and Research Alliance (CHARA). Systems science tools may help CHARA and other CBPR partnerships sustain their core identities while co-evolving in conjunction with individual members, community priorities, and a changing healthcare landscape. Our goal is to highlight CHARA as a case for applying the complementary approaches of CBPR and systems science to (1) improve academic/community partnership functioning and sustainability, (2) ensure that research addresses the priorities and needs of end users, and (3) support more timely application of scientific discoveries into routine practice

Theory of Change: a theory-driven approach to enhance the Medical Research Council's framework for complex interventions.

BACKGROUND: The Medical Research Councils' framework for complex interventions has been criticized for not including theory-driven approaches to evaluation. Although the framework does include broad guidance on the use of theory, it contains little practical guidance for implementers and there have been calls to develop a more comprehensive approach. A prospective, theory-driven process of intervention design and evaluation is required to develop complex healthcare interventions which are more likely to be effective, sustainable and scalable. METHODS: We propose a theory-driven approach to the design and evaluation of complex interventions by adapting and integrating a programmatic design and evaluation tool, Theory of Change (ToC), into the MRC framework for complex interventions. We provide a guide to what ToC is, how to construct one, and how to integrate its use into research projects seeking to design, implement and evaluate complex interventions using the MRC framework. We test this approach by using ToC within two randomized controlled trials and one non-randomized evaluation of complex interventions. RESULTS: Our application of ToC in three research projects has shown that ToC can strengthen key stages of the MRC framework. It can aid the development of interventions by providing a framework for enhanced stakeholder engagement and by explicitly designing an intervention that is embedded in the local context. For the feasibility and piloting stage, ToC enables the systematic identification of knowledge gaps to generate research questions that strengthen intervention design. ToC may improve the evaluation of interventions by providing a comprehensive set of indicators to evaluate all stages of the causal pathway through which an intervention achieves impact, combining evaluations of intervention effectiveness with detailed process evaluations into one theoretical framework. CONCLUSIONS: Incorporating a ToC approach into the MRC framework holds promise for improving the design and evaluation of complex interventions, thereby increasing the likelihood that the intervention will be ultimately effective, sustainable and scalable. We urge researchers developing and evaluating complex interventions to consider using this approach, to evaluate its usefulness and to build an evidence base to further refine the methodology. TRIAL REGISTRATION: Clinical trials.gov: NCT02160249

Key performance indicators for successful simulation projects

There are many factors that may contribute to the successful delivery of a simulation project. To provide a structured approach to assessing the impact various factors have on project success, we propose a top-down framework whereby 15 Key Performance Indicators (KPI) are developed that represent the level of successfulness of simulation projects from various perspectives. They are linked to a set of Critical Success Factors (CSF) as reported in the simulation literature. A single measure called Project’s Success Measure (PSM), which represents the project’s total success level, is proposed. The framework is tested against 9 simulation exemplar cases in healthcare and this provides support for its reliability. The results suggest that responsiveness to the customer’s needs and expectations, when compared with other factors, holds the strongest association with the overall success of simulation projects. The findings highlight some patterns about the significance of individual CSFs, and how the KPIs are used to identify problem areas in simulation projects

Healthcare workers’ perspectives on participatory system dynamics modelling and simulation: designing safe and efficient hospital pharmacy dispensing systems together

With increasingly complex safety-critical systems like healthcare being developed and managed, there is a need for a tool that permits decision-makers to better understand the complexity, test various strategies and guide effective changes. System Dynamics (SD) modelling is an effective approach that can aid strategic decision-making in healthcare systems but has been underutilised partly due to the challenge of engaging healthcare stakeholders in the modelling process. This paper, therefore, investigates the applicability of a participatory SD approach based on healthcare workers' perspectives on ease of use (usability) and usefulness (utility). The study developed an interactive simulation dashboard platform which facilitated participatory simulation for exploring various hospital pharmacy staffing level arrangements and their impacts on interruptions, fatigue, workload, rework, productivity and safety. The findings reveal that participatory SD approach can enhance team learning by converging on a shared mental model, aid decision-making and identifying trade-offs. The implications of these findings are discussed as well as experience and lessons learned on modelling facilitation.Practitioner Summary: This paper reports the perspectives of healthcare workers, who were engaged with a participatory system dynamics modelling and simulation process for hospital pharmacy staffing level management. Evaluative feedback revealed that the participatory SD approach can be a valuable tool for participatory ergonomics by helping the participants gain a deeper understanding of the complex dynamic interactions between workload, rework, safety and efficiency

Engaging Stakeholders To Extend The Lifecycle Of Hybrid Simulation Models

Developing a simulation model of a complex system requires a significant investment of time, expertise and expense. In order to realize the greatest return on such an investment, it is desirable to extend the lifecycle of the simulation model as much as possible. Existing studies typically end after the `first loop' of the lifecycle, with the computer model suitable for addressing the initial requirements of the stakeholders. We explore extending the modeling lifecycle to a `second loop' by introducing an existing hybrid simulation model to a new group of stakeholders and further developing it to capture new requirements. With the aid of an example application, we explain how the hybrid model facilitated stakeholder engagement by closely reflecting the real world and how the model lifecycle has been successfully extended to maximize the benefit to Eurostar International Limited