The Use of Discrete-Event Simulation in Healthcare Operations Research by Eric Goldlust, M.D.,
Dr. Terry Young , Professor of Healthcare Systems, School of Information Systems, Computing and Mathematics, Brunel University
He and Dr. James Fackler published a paper Why healthcare professionals are slow to adopt modeling and simulation? to explore the reason for slow adoption of the computer modeling and simulation in healthcare.
Professo Young is also the co-founder of the Cumberland Initiative, a network of leading clinicians, managers, modellers, academics and industry specialists who are pioneering the modeling and simulation approach in the NHS. Lord Norman Warner, former Health Minister for NHS reform said in a press conference.
“We will only do something different if we have an analytical base to enable people to change,” argued Lord Warner. “The problem in the NHS is, unless local people are confronted with overwhelming evidence that something has to be done and there is another way, in many places they don’t change their institutional behaviour.”
“The NHS is a very conservative organisation in many places. But where we are now, we badly need the kind of initiative that Cumberland is showing. The traditional thing you do is try and gee up doctors and managers but we need a bit of an injection of data collection and analysis.”
In 2005, the National Academy of Engineering and the Institute of Medicine published consensus report Building a Better Delivery System- A New Engineering/Health Care Partnership. 2009, AHRQ published Industrial and Systems Engineering and Health Care: Critical Areas of Research. Both those reports introduce the great potential of systems engineering application in healthcare. As as recent AHRQ recenty Patient Safety Learning Laboratories: Innovative Design and Development to Improve Healthcare Delivery Systems (P30) stated “Despite the carefully crafted recommendations and thoughtful papers, its impact has been limited. ” This education module will be a great help to fill the gap for healthcare providers’ education. Thank you !
At Institute for Healthcare Improvement National Forum, Don Berwick, MD, former CMS administrator used a 1930s engineering feat in Honduras as a metaphor for today’s healthcare system.
The Choluteca Bridge was built by the U.S. Army Corps of Engineers with such design strength, it could withstand the worst of hurricanes that affected the area. When Hurricane Mitch came in 1998, it destroyed 150 Honduran bridges, but not the Choluteca Bridge. Instead, the storm rerouted the Choluteca River. So now, the Choluteca Bridge is useless.
More detail from Iowa Hospital Association blog:
Dr. Don Berwick declared that today’s health care organizations are like the Choluteca Bridge. They were designed and built for a different river – the river of heavy-duty, high-volume, invasive procedures. The river of serious illness. While the temptation is great to try and redirect the massive river to flow back under the first bridge, the work set before health care leaders is to build a new bridge – a bridge of authentic prevention. Dr. Berwick said, “Hospitals cure disease but they do not prevent it. And they cannot prevent it, because they aren’t set up to do that today. Prevention doesn’t have any cathedrals. The result is a continuing misallocation of effort. If the Martians came here to visit, they would call this insane. We let bad things happen and then fix them. Well, why don’t we stop them from happening? Simply put, we just haven’t built the institutional structure for prevention.” – See more at: http://blog.iowahospital.org/2013/08/22/a-bridge-where-the-river-flows-no-more/#sthash.xSJPVPm1.dpuf
The National Academy of Engineering and Institute of Medicine of the National Academies directed attention to the issue of systems engineering and integration with their joint report in 2005, “Building a Better Delivery System: A New Engineering/Health Care Partnership.” The collaboration between clinicians, engineers, researchers, educators, and experts from medical informatics and management will analyze, define, design, develop, test and implement high value and comprehensive solutions to many of the challenging problems in clinical medicine.