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MASHnet Launch – 20 Sept 05

Modelling Healthcare - making it work. A full review of the very successful MASHnet launch day event including outputs from the presentations and interactive sessions.

Warwick Business SchoolThis event held at Warwick University Business School was a full house with over seventy participants active in the area of healthcare modelling – drawing from many areas of the health service, academic research and industry.

Keynote Presentations

Geoff Royston

Dr Geoff Royston is Head of Profession for OR. in the Dept. of Health and works in the Dept’s Strategy Directorate. Work includes developing methods for allocating health care resources to localities, improving communication of clinical risks, reducing waiting times, evaluating NHS modernisation programmes. Recently he has worked on “expert patients” and support for self-care. He was responsible for the concept of “NHS Direct” as a multi-channel service and led the first stages of its implementation. He has directed the programme of DoH work on health applications of digital TV and a satellite TV service “NHS Direct Interactive” which went “on air” in Dec 2004 now reaches 10 million in the UK.

PRESENTATION: Modelling and Simulation in Health – Potential, Achievement and Challenge Geoff Royston Presentation

Commences with some background on recent major developments in UK health care and a short overview on modelling. It provides some illustrations of modelling and simulation in the UK health sector, including some from the work of OR analysts in the DH. The talk then highlights some key issues for the UK health sector in the early 21st century and the challenges and opportunities these present for members of MASHnet.

Professor Ruth Davies – Head of the Operational Research and Information Systems Group at Warwick Business School. Her expertise is in modelling health systems, using simulation to describe the interaction between the parts in order to evaluate current and potential future policies. Over the past few years she has run several substantial projects, funded by the Department of Health, in order to advise on policy. She has many active roles in this area and was co-editor of the February 2005 Special Issue of the Journal of the OR Society dedicated to “Meeting Health Challenges with OR”.

PRESENTATION: OR, Academics and the Health Service Ruth Davies Presentation

Looks at the relationship between OR and the Health Service using a hospital and a disease based case study. Demonstrates that academic research needs to take a broad view, both developing and exploiting new techniques and also taking account of the objectives of a range of stakeholders. Whilst academics are also concerned with implementation and change, they and the “users” will benefit from closer links with practitioners and software developers. We anticipate that MASHnet will facilitate this.

Dr Mark Elder – CEO of SIMUL8 Corporation, a company he founded in 1994 because a radiology manager could not find simulation software that could answer his simple question: Should I build an additional radiology room, or hire an additional nurse? – Which would best reducing patient waiting times? Since then SIMUL8 Corp as driven forward the idea of simulation as a tool for gathering evidence for change, that works just as well for the service sector as it has for decades in manufacturing.

PRESENTATION: Developing Models of Health Mark Elder Presentation

Mark’s talk uses a number of recent examples of healthcare simulation models to highlight some do’s and don’ts in simulation modelling. He shows us some of the numerical and non-numerical benefits of spending time on modelling.

Dr Simon Dodds – born and educated in Yorkshire, won an Open Scholarship to read Medicine at Cambridge in 1979. He chose a Part II in Computer Science and after completing his medical degree at St Bart’s Hospital in London he trained in surgery in London, Cambridge and Wessex. At Southampton he was awarded his MS degree in 1994 for research on computer modelling the haemodynamics of occlusive arterial disease and was appointed a consultant vascular surgeon at Good Hope Hospital in 1999. Since then he has combined his experience in medicine, research and computer science to improve vascular surgery services at Good Hope. In 2004 his team were awarded the NHS Innovation Award for Service Delivery for the Leg Ulcer Telemedicine Service. His current projects include the application of discrete event simulation (DES) to the design of improved healthcare processes for which he was awarded the HITEA 2005 Best use of IT in the Health Service for the successful implementation of the DES-designed One Stop Vascular Surgery Clinic.

PRESENTATION: Designing win-win-win solutions for improved healthcare performance – it is possible! Simon Dodds Presentation

The current challenges in delivering high quality, cost effective healthcare are not lack of medical knowledge but ineffective delivery of existing knowledge. Applied OR in healthcare delivery has great potential to dramatically improve existing services. Over the last five years these principles were used to redesign the vascular surgery outpatient service at Good Hope Hospital. A discrete event simulation (DES) has been designed that predicted a possible increase of 40% in maximum clinic capacity using existing resources. Simulations were verified by successfully implementing the best model in practice – resulting in a win-win-win outcome for patients, staff and the hospital. The principles and methods of OR/OM require specific knowledge, skills and experience to apply safely. Active diffusion of innovation requires – support for further innovation, appropriate software tools, end-user training, and a programme of training successive waves of early adopters. The goal is the tipping point where the momentum generated is sufficient to complete the paradigm shift to a culture of evidence-based healthcare management.

Output From Interactive Sessions

Break-out sessions were held in the afternoon of the launch event in which groups of about eight people were each asked to complete a grid which outlined their responses to a each of the following four questions from the perspective of the three main sectors addressed by MASHnet (i.e. Health Services, Academic Research, and Industry)

  1. Why is health care modelling and simulation important?
  2. What are the main obstacles to its successful application?
  3. What actions can be taken to overcome these obstacles?
  4. What are the most important issues arising?

Grid Outputs – typed version

Grid from the Pink Group

Grid from the Red Group

Grid from the Orange Group

Grid from the Yellow Group

Grid from the Green Group

Grid from the Dark Blue Group

Grid from the Light Blue Group

Grid from the Purple Group

Big Ideas

All participants at the MASHnet launch were asked to fill in a ‘Big Idea’ response form which asked for one idea which would improve the application of modelling and simulation in health care. These responses are listed below:

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