Modelling and simulating unplanned and urgent healthcare: the contribution of scenarios of future healthcare systems.

The current financial challenges being faced by the UK economy have meant that the NHS will have to make £20 billion of savings between 2010 and 2014 requiring it to be innovative about how it delivers healthcare. This paper presents the methodology of a research project that is simulating the whole healthcare system with the aim of reducing waste within urgent unscheduled care streams whilst understanding the impact of such changes on the whole system. The research is aimed at care commissioners who could use such simulation in their decision-making practice, and the paper presents the findings from early stakeholder discussions about the scope and focus of the research and the relevance of stakeholder consultation and scenarios in the development of a valid decision-support tool that is fit for purpose

A multi-faceted approach to optimising a complex unplanned healthcare system

Unscheduled and urgent health care represents the largest area of activity and cost for the UK’s National Health Service (NHS). Like typical complex systems unplanned care has the features of interdependence and having structures at different scales which requires modelling at different levels. The aim of this paper is to discuss the development of a multifaceted approach to study and optimise this complex system. We aim to integrate four different methodologies to gain better understanding of the nature of the system and to develop ways to enhance its performance. These methodologies are: (a) Lean/ Flow theory to look at the process and patients and other flows; (b) Simulation/ System Dynamics to undertake analytical analysis and multi-level modelling; (c) stakeholder consultation and use of system thinking to analyse the system and identify options, barriers and good practice; and (d) visual analytic modelling to facilitate effective decision making in this complex environment. Of particular concern are the boundary issues i.e. how changes in unplanned care will impact on the adjacent facilities and ultimately on the whole Healthcare system

Sensitivity analysis in a scoping review on police accountability : assessing the feasibility of reporting criteria in mixed studies reviews

In this paper, we report on the findings of a sensitivity analysis that was carried out within a previously conducted scoping review, hoping to contribute to the ongoing debate about how to assess the quality of research in mixed methods reviews. Previous sensitivity analyses mainly concluded that the exclusion of inadequately reported or lower quality studies did not have a significant effect on the results of the synthesis. In this study, we conducted a sensitivity analysis on the basis of reporting criteria with the aims of analysing its impact on the synthesis results and assessing its feasibility. Contrary to some previous studies, our analysis showed that the exclusion of inadequately reported studies had an impact on the results of the thematic synthesis. Initially, we also sought to propose a refinement of reporting criteria based on the literature and our own experiences. In this way, we aimed to facilitate the assessment of reporting criteria and enhance its consistency. However, based on the results of our sensitivity analysis, we opted not to make such a refinement since many publications included in this analysis did not sufficiently report on the methodology. As such, a refinement would not be useful considering that researchers would be unable to assess these (sub-)criteria

Which is more appropriate: a multi-perspective comparison between systems dynamics and discrete event simulation

System Dynamics (SD) and Discrete Event Simulation (DES) are two established simulation tech-niques for simulating the dynamics of a system. Both have been widely used in modelling business de-cisions. This paper presents meta-comparison between the two approaches based on literature survey. Upon reviewing the existing literature it has been identified that existing comparisons could be classi-fied under three main perspectives: Systems perspective, Problems perspective and Methodology per-spective. The nature of system and nature of problem have been argued as primary factors for decid-ing modelling methodology. Therefore SD and DES comparisons have been classified on the basis of systems, problems and inherent aspects and capabilities of both modelling methods. It has been ar-gued that development of sound models need fit between system, problem and methodology. The suc-cess of model depends on it’s technical soundness as well as it’s successful implementation. In order to develop successful models this vision has been further extended to incorporate stakeholders, re-sources and time

Mapping the information-coping trajectory of young people coping with long term illness: An evidence based approach

Purpose - Purpose: We explore the relationship between information and coping information from the experiences of young people coping with long term illness. Design/methodology/approach - Methodology: Situational Analysis was used as a methodological approach. It has roots in the Chicago Symbolic Interactionism School. Cartographic approaches enabled the analysis, mapping the complexities emerging from the data. Findings - Findings: As the young people became more informed about their health conditions, and gained knowledge and understanding both about their illnesses, their own bodies and boundaries, their confidence and capacity to cope increased. Gaining confidence, the young people often wanted to share their knowledge becoming information providers themselves. From the data we identified five positions on an information-coping trajectory (1) Information deficiency (2) Feeling ill-informed (3) Needing an injection of information (4) Having information health and (5) Becoming an information donor. Research limitations/implications - Research limitations/implications: The research was limited to an analysis of thirty narratives. The research contributes to information theory by mapping clearly the relationship between information and coping. Originality/value - Originality/value: The information theories in this study have originality and multi-disciplinary value in the management of health and illness, and information studies