Emergency Service Simulation

Outline

The Trust Service Development team co-ordinated extensive discussions with a wide range of clinicians, managers, and other key stakeholders to identify the problems with the current system and to develop the project aspirations. The concept of a ‘Hub Model’ and clarifying its meaning amongst the key participants was crucial in determining the desired emergency service model.

The ‘PatientFlow Planning’ software was introduced as a visual process for mapping and recording information about different pathways of care. Having decided the twelve key questions to be answered, the simulation model guided the team to successful modelling. The result of the this work is a model which can vary demand from different patient cohorts, vary the provision of Staff resources, and vary the provision of physical resources (beds, chairs etc.) The model then estimates the impact of these changes in terms of the patients, staff and finances.

Evaluation

The key strengths of this tool is in enhancing communication and effective strategic decision making. The abilty to ask ‘what if’ questions also proved invaluable.

Lessons learnt:

• The tool enabled use to produce a series of drawings that could store all the important data relating to the likely pathways of emergency admisssions via the Emergency Department and GP referrals through the EMU. Front-line medical staff were involved throughout the process which enabled clinical ownwership of the work. This is critical for the final success of the proposal.
• Although the mapping and simulation is much more than raw data analysis, all data inputted must be consistent with historically recorded data. All assumptions built into the model must be based on subjective experiences of the front-line staff. Data quality is key to a robust foundation for modelling.
• Working with a partner who understands NHS processes is essential.