Facilitated post-model coding in discrete event simulation (DES): a case study in healthcare

Research on facilitated discrete event simulation (DES) is gathering pace but there is still a need to put forward real examples to explain the process to newcomers. This paper is part of a line of research on the methodology of facilitated DES. In this paper we explain in more detail the facilitation process and the tools used to support the experimentation and implementation stages in a DES study involving workshops with a group of stakeholders, after an initial simulation model has been coded on the computer. A real case study is used to describe the process followed and the interactions at the workshops. Extracts from the transcripts are also included, with the view to providing evidence of the stakeholders’ involvement and their mood during the workshops. We conclude with a discussion on the process and tools used to support the facilitation process. Future research directions are also put forward

Towards Self-Adaptive Discrete Event Simulation (SADES)

Systems that benefit from the ongoing use of simulation, often require considerable input by the modeller(s) to update and maintain the models. This paper proposes automating the evolution of the modelling process for discrete event simulation (DES) and therefore limiting the majority of the human modeller’s input to the development of the model. This mode of practice could be named Self-Adaptive Discrete Event Simulation (SADES). The research is driven from ideas emerging from simulation model reuse, automations in the modelling process, real time simulation, dynamic data driven application systems, autonomic computing and self-adaptive software systems. This paper explores some of the areas that could inform the development of SADES and proposes a modified version of the MAPE-K feedback control loop as a potential process. The expected outcome from developing SADES would be a simulation environment that is self-managing and more responsive to the analytical needs of real systems

A Facilitation Workshop for the Implementation Stage: A Case Study in health care

Research on facilitation in discrete event simulation (DES) is gathering pace but there is still a need to put forward real examples to explain the process to newcomers. Most of the research has focussed on facilitation in the initial stages of the simulation modelling process. In this paper we focus on one of the postmodel coding stages. More specifically we focus on the implementation stage, the final stage in the modelling process. The primary contributions of this paper are the description of the process followed and the introduction of tools that can be used during this stage to support workshop activities. A real case study is provided describing the sequence of the interactions undertaken in the workshop. Extracts from the transcripts are also included, with the view to bringing evidence of the stakeholders’ involvement and their mood during the workshop. The paper concludes with a discussion on the process followed and the importance of using tools in this stage

A facilitation workshop for the implementation stage: A case study in health care

Research on facilitation in discrete event simulation (DES) is gathering pace but there is still a need to put forward real examples to explain the process to newcomers. Most of the research has focussed on facilitation in the initial stages of the simulation modelling process. In this paper we focus on one of the postmodel coding stages. More specifically we focus on the implementation stage, the final stage in the modelling process. The primary contributions of this paper are the description of the process followed and the introduction of tools that can be used during this stage to support workshop activities. A real case study is provided describing the sequence of the interactions undertaken in the workshop. Extracts from the transcripts are also included, with the view to bringing evidence of the stakeholders’ involvement and their mood during the workshop. The paper concludes with a discussion on the process followed and the importance of using tools in this stage

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

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

A participative and facilitative conceptual modelling framework for discrete event simulation studies in healthcare

Existing approaches to conceptual modelling (CM) in discrete-event simulation (DES) do not formally support the participation of a group of stakeholders. Simulation in healthcare can benefit from stakeholder participation as it makes possible to share multiple views and tacit knowledge from different parts of the system. We put forward a framework tailored to healthcare that supports the interaction of simulation modellers with a group of stakeholders to arrive at a common conceptual model. The framework incorporates two facilitated workshops. It consists of a package including: three key stages and sub-stages; activities and guidance; tools and prescribed outputs. The CM framework is tested in a real case study of an obesity system. The benefits of using this framework in healthcare studies and more widely in simulation are discussed. The paper also considers how the framework meets the conceptual modeling requirements

Can involving clients in simulation studies help them solve their future problems? A transfer of learning experiment

It is often stated that involving the client in operational research studies increases conceptual learning about a system which can then be applied repeatedly to other, similar, systems. Our study provides a novel measurement approach for behavioural OR studies that aim to analyse the impact of modelling in long term problem solving and decision making. In particular, our approach is the first to operationalise the measurement of transfer of learning from modelling using the concepts of close and far transfer, and overconfidence. We investigate learning in discrete-event simulation (DES) projects through an experimental study. Participants were trained to manage queuing problems by varying the degree to which they were involved in building and using a DES model of a hospital emergency department. They were then asked to transfer learning to a set of analogous problems. Findings demonstrate that transfer of learning from a simulation study is difficult, but possible. However, this learning is only accessible when sufficient time is provided for clients to process the structural behaviour of the model. Overconfidence is also an issue when the clients who were involved in model building attempt to transfer their learning without the aid of a new model. Behavioural OR studies that aim to understand learning from modelling can ultimately improve our modelling interactions with clients; helping to ensure the benefits for a longer term; and enabling modelling efforts to become more sustainable

Redox stress shortens lifespan through suppression of respiratory complex I in flies with mitonuclear incompatibilities

Incompatibilities between mitochondrial and nuclear genes can perturb respiration, biosynthesis, signaling and gene expression. Here we investigate whether mild mitonuclear incompatibilities alter the physiological response to redox stress induced by N-acetyl cysteine (NAC). We studied three Drosophila melanogaster lines with mitochondrial genomes that were either coevolved (WT) or mildly mismatched (BAR, COX) to an isogenic nuclear background. Responses to NAC varied substantially with mitonuclear genotype, sex, tissue and dose. NAC caused infertility and high mortality in some groups, but not others. Using tissue-specific high-resolution fluorespirometry, we show that NAC did not alter H2O2 flux but suppressed complex I-linked respiration in female flies, while maintaining a reduced glutathione pool. The high mortality in BAR females was associated with severe (>50 %) suppression of complex I-linked respiration, rising H2O2 flux in the ovaries, and significant oxidation of the glutathione pool. Our results suggest that redox stress is attenuated by the suppression of complex-I linked respiration, to the point of death in some mitonuclear lines. We propose that suppression of complex I-linked respiration is a general mechanism to maintain redox homeostasis in tissues, which could offset oxidative stress in ageing, producing a metabolic phenotype linked with epigenetic changes and age-related decline

A Tutorial on Involving Stakeholders in Facilitated Simulation Studies

This tutorial introduces the PartiSim approach, aimed at supporting analysts and simulation modellers to carry out facilitated discrete event simulation studies. Facilitated simulation offers an alternative mode of engagement with stakeholders (clients) in simulation projects. It is particularly beneficial when modelling systems with complex behaviour, involving many stakeholders with plurality of opinions and objectives. PartiSim short for Participative Simulation, is a facilitated modelling approach developed to support simulation projects through a framework, stakeholder-oriented tools and manuals in facilitated workshops. A PartiSim study includes six stages, four of which involve facilitated workshops. PartiSim was developed more than 10 years ago. It can be applied to analyse operational problems in many contexts within the services and manufacturing domain. This tutorial presents the PartiSim framework and tools, some applications and example tools, a roadmap to adopting it and concludes with some tips for potential users