Developing a participative user tool to aid the conceptual development of simulation models in healthcare.

Lead Research Organisation: University of Warwick
Department Name: Warwick Business School


The NHS spending is expected to increase from 70 billion a year to more than 90 billion by 2007/8 but this may not be enough for the government to achieve the planned health care delivery targets because it faces new challenges such as the increasing demands of a population that is living longer. Patients will only benefit from this increase in spending if the health care delivery system is more efficient and effective. Discrete event simulation modelling has been touted as an ideal tool in assisting decision makers in bringing about efficiency in health care as it is able to model its inherent complexity and variability and as a result hundreds of simulation models have been built over the last 30 years but only a handful of these have reported implementation or have impacted on policy. Evidence suggests that one factor inhibiting implementation is the limited participation of health care decision makers and stakeholders in the model development. The most important part of model development is conceptual modelling because it is about deciding what and how to model. Currently there are no formal approaches to aid the development of conceptual models in health care. We propose to develop an approach stemming from the problem structuring field of Operational Research that will specifically aim to help health care administrators and clinicians take a more active part in the development of health care conceptual models. We also expect that a more active part will lead them to buy in to the process and findings and to support their implementation. Finally, we expect that this will enable both expert and novice modellers to build more relevant discrete event simulation models in health care by better communicating with stakeholders.


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A Tako (Co-Author) (2010) A conceptual modelling framework for stakeholder participation in simulation studies in Proceedings of the OR Society's Two-Day Workshop (SW10),

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Kotiadis K (2018) Facilitated post-model coding in discrete event simulation (DES): A case study in healthcare in European Journal of Operational Research

Description The rational for this research was to improve communication between modellers' stakeholders in health care simulation studies, in order to increase the likelihood of successful study outcomes such as generating learning and implementation of the findings. Stakeholder participation in a simulation study has the potential to enhance the sense of model ownership and confidence in the results of the study. We have developed a participative and facilitative approach for discrete event simulation studies, which is supported by a framework with tools, manuals and scripts. The product of this research takes the form of a paper based toolbox consisting of: A. a user guide describing the framework and its stages and B. a toolset for each PartiSim stage, consisting of the tools, (tool) manuals and scripts (for the facilitator). The approach, known as PartiSim, stands for Participative Simulation in Healthcare. The key feature of the PartiSim approach is the development of simulation models through a series of facilitated stakeholder workshops. The facilitated workshops provide stakeholders with a platform to air facts and opinions that could impact the success of the intervention. In addition, the modelling team have a comprehensive yet simple and practical approach to support them throughout the study. In addition, this approach could be useful in teaching the simulation modelling process to students, yet also support novice modellers that may have the technical expertise but lack in experience of client interaction. Although we originally aimed at supporting conceptual modelling (stages prior to computer model coding), the PartiSim approach broadens the original scope of the study by supporting all the key stages of a simulation study. Therefore, PartiSim supports stakeholders engage in a simulation study from problem structuring (part of conceptual modelling) through to implementation (deciding what action should be taken). The PartiSim approach has been trialled in real simulation studies in health care, consisting of just four workshops with individual workshop duration that that did not exceed two hours. Our industrial collaborators that are representative of UK health care stakeholders, in initial consultations, set a two hour target for each workshop. Providing an approach that can meet this target, is a considerable achievement as other facilitated management science approaches generally report much longer workshop durations. In addition the stakeholder feedback was positive and very supportive of the research rational, with our trials of the approach leading to stakeholder learning and implementation.
Exploitation Route The PartiSim research and findings can be put into use if academics teach the approach and if practitioners adopt it. The research findings have been presented to academics at international conferences and a training course will run from 2012
Sectors Healthcare

Title PartiSim toolbox 
Description Note: the options above do not fit so one has been chosen at random. This framework and toolbox is aimed at enabling facilitative discrete event simulation modelling. 
Type Of Material Technology assay or reagent 
Year Produced 2010 
Provided To Others? Yes  
Impact It means that simulation modellers can interact in a systematic way with a group of clients during the development of models. This means that clients can ensure that useful models are built. It moves simulation away from being a model centered process to a client centered process. 
Description Charing Cross Hospital 
Organisation Charing Cross Hospital
Country United Kingdom 
Sector Hospitals 
Start Year 2007
Description King's College Hospital 
Organisation King's College Hospital
Country United Kingdom 
Sector Hospitals 
Start Year 2007
Description Medway NHS Trust 
Organisation Medway NHS Foundation Trust
Country United Kingdom 
Sector Public 
Start Year 2007