Health Modelling
Posted: Wed Apr 23, 1997 1:51 pm
Andy Mather Wrote:
"I am interesting in modelling hospital bed management in a publicly funded
University hospital- with particular reference to resolving the difficulty
of emergency patients accessing beds without disrupting the access for
waiting list patients . Is there anyone who can point to any work in this
area??"
We have a project here at LSE, involving me, Prof. Rosenhead and a Research
Assistant which seems to have amazing similarities to your interests.
The work was originally commissioned by Southwark Community Health Council as
a part of their work on the Casualty Watch Survey. The survey has been running
for five years, and arose as a result of public concern that cuts in the
National Health Service were producing an inadequate service in general, and
pressure on Accident and Emergency (A&E) in London in particular. The Casualty
Watch survey only provides a snap-shot of the situation in A&E in that it only
records the time patients have been waiting in A&E up to the moment of the visit
by the Casualty Watch worker. But it made a good start point. . .
In the summer of 1995 an MSc OR project was established to build a system
dynamics model to investigate the sensitivity of patient waiting time in
casualty to different factors which might influence A&E performance, with
particular interest on the impact of hospital bed capacity.
The work done in 1995 resulted in a prototype model of an A&E department and
during a subsequent project by an LSE student the model was been developed
further to fit an A&E department of a particular London hospital. There is now a
Research Assistant working on the issue full time.
Factors incorporated within the current model include arrival rates to A&E
(self-referrals, GP referrals) and hospital wards (planned elective admissions),
procedures necessary to determine whether hospital admission is required for A&E
patients, the availability of resources required to perform these procedures and
the dynamic reallocation of those resources, the availability of hospital beds
etc. Key performance indicators include waiting time for admission, and
cancellation of elective admissions. Policy alternatives which can be considered
include the level of resources (beds, staff in various categories), and
alternative strategies for the employment of these resources.
We have, in the last two weeks, secured access to the most senior staff of
the A&E unit of a major London hospital. We have therefore begun to conduct
interviews with them in order to confirm and develop the structure of the model,
as well as using their data and getting their ideas about the policy issues that
are of greatest relevance.
We are taking a slow and cautious approach to this study because it concerns
a very contentious issue in the UK. However, we are very excited about this
work, about the access that we have agreed, the features of the model being
developed and, most of all, the opportunity that it presents for us to
contribute to an important public policy debate.
Regards,
David
________________________________________________________________________________
Dr. David C. Lane
Operational Research Department
London School of Economics and Political Science
Houghton Street Tel. (44) (0) 171-955-7336
London WC2A 2AE Fax. (44) (0) 171-955-6885
United Kingdom e-mail: d.c.lane@lse.ac.uk
"I am interesting in modelling hospital bed management in a publicly funded
University hospital- with particular reference to resolving the difficulty
of emergency patients accessing beds without disrupting the access for
waiting list patients . Is there anyone who can point to any work in this
area??"
We have a project here at LSE, involving me, Prof. Rosenhead and a Research
Assistant which seems to have amazing similarities to your interests.
The work was originally commissioned by Southwark Community Health Council as
a part of their work on the Casualty Watch Survey. The survey has been running
for five years, and arose as a result of public concern that cuts in the
National Health Service were producing an inadequate service in general, and
pressure on Accident and Emergency (A&E) in London in particular. The Casualty
Watch survey only provides a snap-shot of the situation in A&E in that it only
records the time patients have been waiting in A&E up to the moment of the visit
by the Casualty Watch worker. But it made a good start point. . .
In the summer of 1995 an MSc OR project was established to build a system
dynamics model to investigate the sensitivity of patient waiting time in
casualty to different factors which might influence A&E performance, with
particular interest on the impact of hospital bed capacity.
The work done in 1995 resulted in a prototype model of an A&E department and
during a subsequent project by an LSE student the model was been developed
further to fit an A&E department of a particular London hospital. There is now a
Research Assistant working on the issue full time.
Factors incorporated within the current model include arrival rates to A&E
(self-referrals, GP referrals) and hospital wards (planned elective admissions),
procedures necessary to determine whether hospital admission is required for A&E
patients, the availability of resources required to perform these procedures and
the dynamic reallocation of those resources, the availability of hospital beds
etc. Key performance indicators include waiting time for admission, and
cancellation of elective admissions. Policy alternatives which can be considered
include the level of resources (beds, staff in various categories), and
alternative strategies for the employment of these resources.
We have, in the last two weeks, secured access to the most senior staff of
the A&E unit of a major London hospital. We have therefore begun to conduct
interviews with them in order to confirm and develop the structure of the model,
as well as using their data and getting their ideas about the policy issues that
are of greatest relevance.
We are taking a slow and cautious approach to this study because it concerns
a very contentious issue in the UK. However, we are very excited about this
work, about the access that we have agreed, the features of the model being
developed and, most of all, the opportunity that it presents for us to
contribute to an important public policy debate.
Regards,
David
________________________________________________________________________________
Dr. David C. Lane
Operational Research Department
London School of Economics and Political Science
Houghton Street Tel. (44) (0) 171-955-7336
London WC2A 2AE Fax. (44) (0) 171-955-6885
United Kingdom e-mail: d.c.lane@lse.ac.uk