THE DESIGN AND ANALYSIS OF EXPERIMENTS. By Oscar Kempthorne. New York, John Wiley and Sons, Inc., 1952. 631 pp. $8.50. This book by a teacher of statistics (as well as a consultant for \"experimenters\") is a comprehensive study of the philosophical background for the statistical design of experiment. It is necessary to have some facility with algebraic notation and manipulation to be able to use the volume intelligently. The problems are presented from the theoretical point of view, without such practical examples as would be helpful for those not acquainted with mathematics. The mathematical justification for the techniques is given. As a somewhat advanced treatment of the design and analysis of experiments, this volume will be interesting and helpful for many who approach statistics theoretically as well as practically. With emphasis on the \"why,\" and with description given broadly, the author relates the subject matter to the general theory of statistics and to the general problem of experimental inference. MARGARET J. ROBERTSON

The Design and Analysis of Experiments

Discrete Event Simulation (DES) has been widely used in modelling health-care systems for many years and a simple citation analysis shows that the number of papers published has increased markedly since 2004. Over the last 30 years several significant reviews of DES papers have been published and we build on these to focus on the most recent era, with an interest in performance modelling within hospitals. As there are few papers that propose or illustrate general approaches, we classify papers according to the areas of application evident in the literature, discussing the apparent lack of genericity. There is considerable diversity in the objectives of reported studies and in the consequent level of detail: We discuss why specificity dominates and why more generic approaches are rare.

/pdf/discrete-event-simulation-for-performance-modelling-in-2pbcbcdgca.pdf

Discrete event simulation for performance modelling in health care: a review of the literature

https://repositorio.inesctec.pt/bitstream/123456789/3167/1/PS-06772.pdf

Operations Research in Healthcare: a survey

Outpatient appointment systems in healthcare: A review of optimization studies

Modelling has been used extensively by all national governments and the World Health Organisation in deciding on the best strategies to pursue in mitigating the effects of COVID-19. Principally the...

https://www.tandfonline.com/doi/pdf/10.1080/17477778.2020.1751570

How simulation modelling can help reduce the impact of COVID-19

Healthcare systems aspire to offer an effective and efficient provision of health service without compromising on quality. Hospitals are important links in the healthcare service chain, and Operational Research/Management Science methods have an essential role to play in helping to improve the planning and management of hospitals. In particular, simulation methods have been widely used by healthcare researchers and practitioners. This paper is written as a guide for building hospital simulation models and is based on the author's experience and the published literature. Two points of view emerge in this paper supporting each other: a conceptual view and a technical view. Initially, conceptual issues are discussed, including topics such as framing and specification, level of model detail, and data requirements. Second, a technical point of view buttresses the discussion from the methodological side and three simulation methods are evaluated, namely: Discrete Event Simulation, System Dynamics, and Agent-Based Simulation.

/pdf/a-guide-for-building-hospital-simulation-models-5e9xeq72h4.pdf

A guide for building hospital simulation models

As part of a larger project examining the effect of performance targets on UK hospitals, we present a simulation of an Accident and Emergency (A&E) Department. Performance targets are an important part of the National Health Service (NHS) performance assessment regime in the UK. Pressures on A&Es force the medical staff to take actions meeting these targets with limited resources. We used simulation modelling to help understand the factors affecting this performance. We utilized real data from patient admission system of an A&E and presented some data analysis. Our particular focuses are the multitasking behaviour and experience level of medical staff, both of which affect A&E performance. This performance affects, in turn, the overall performance of the hospital of which it is part.

/pdf/understanding-accident-and-emergency-department-performance-28nahnxohj.pdf

Understanding accident and emergency department performance using simulation

National Health Service (NHS) performance targets in England have put pressure on hospital management to reduce waiting times. The stochastic nature of emergency patient arrivals creates problems for capacity planning for elective patients. We present a whole hospital model which can be used at policy level to investigate cause and effect relations, such as effects of increased emergency arrival volumes on elective waiting times. A typical general hospital can be abstracted in three main units; Accident and Emergency (A&E) department, outpatient clinics, and inpatient units. In real life these units are coupled and share hospital resources. We developed three discrete event simulation (DES) models for each unit to form a whole hospital DES model. We present our models conceptually and our main discussion is on the level of detail in these three models.

/pdf/interconnected-des-models-of-emergency-outpatient-and-43b44xpi03.pdf

Interconnected DES models of emergency, outpatient, and inpatient departments of a hospital

The British National Health Service (NHS) has a performance management framework that aims to guarantee short waiting times for patients by including mandatory targets for hospitals. DGHPSim is a suite of four components that simulates the activities of an NHS general hospital to show the effect of different policies on waiting times in these hospitals. DGHPSim has a generic structure that is used to simulate a particular hospital by employing data appropriate to that hospital from available data sets. Two of the components of DGHPSim, the accident and emergency simulator and the outpatient simulator, may be used independently as stand-alone simulators of these hospital functions. The DGHPSim suite incorporates a novel way of simulating the multitasking behavior of clinicians and uses transition matrices, extracted from standard datasets, to represent the states through which patients pass and the wards in which they may be treated. As a whole, the DGHPSim suite may be used to investigate improvement options before their implementation or to investigate how a hospital has improved its performance. We show how DGHPSim is used to investigate reported performance improvements in an English general hospital.

Murat M. Gunal

Papers

Discrete event simulation for performance modelling in health care: a review of the literature

A guide for building hospital simulation models

Understanding accident and emergency department performance using simulation

Interconnected DES models of emergency, outpatient, and inpatient departments of a hospital

DGHPSIM: Generic simulation of hospital performance