Application of Simulation in Healthcare Service Operations: A Review and Research Agenda
31 Dec 2020-ACM Transactions on Modeling and Computer Simulation (ACMPUB27New York, NY, USA)-Vol. 31, Iss: 1, pp 1-23
TL;DR: In this article, the authors analyze healthcare simulation literature of the past decade (2007-2016) that addresses operations management issues in various healthcare service delivery levels and categorizes the literature accordingly.
Abstract: The health system is intricate due to its dynamic nature and critical service requirements. The involvement of multiple layers of health service providers quadrupled this complexity and results in a complicated operating environment. Simulation is often considered an apt technique to model and study complex systems in the literature. The popularity of simulation in the healthcare domain had only accelerated with time and resulted in a large number of articles intended to solve myriad healthcare problems. This article analyzes healthcare simulation literature of the past decade (2007--2016) that addresses operations management issues in various healthcare service delivery levels and categorizes the literature accordingly. In the next step, we attempt to assimilate the entire literature to capture specific health issues addressed, operations management concepts applied, and simulation methods used, and identify major research gaps. Finally, we develop the research agenda from dividing these gaps into the contextual, conceptual, and methodological genre that is consistent with the previous state-of-the-art literature reviews in operations management. Furthermore, this article demonstrates other minute aspects such as “sources of funding” and “tools used for the research” to maintain coherence with the previous reviews in the healthcare simulation. The objective of this work is twofold: to connect the knowledge continuum to the present, and to provide potential research directions for future academicians.
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TL;DR: In this paper , the authors focus on five general characteristics of the problem that should be carefully considered for any healthcare project that requires implementation and summarize what short and long-term steps the operational research community can take that will lead to improvement in each of these areas.
2 citations
TL;DR: In this article, a systematic search was conducted between 2000 and 2018, in 5 academic databases (ACM D. Library, CINAHL, IEEE Xplore, PubMed, Web of Science) complemented with grey literature from Google Scholar.
Abstract: Background The guiding principle of many health care reforms is to overcome fragmentation of service delivery and work towards integrated healthcare systems. Even though the value of integration is well recognized, capturing its drivers and its impact as part of health system performance assessment is challenging. The main reason is that current assessment tools only insufficiently capture the complexity of integrated systems, resulting in poor impact estimations of the actions taken towards the 'Triple Aim'. We describe the unique nature of simulation modeling to consider key health reform aspects: system complexity, optimization of actions, and long-term assessments. Research question How can the use and uptake of simulation models be characterized in the field of performance assessment of integrated healthcare systems? Methods A systematic search was conducted between 2000 and 2018, in 5 academic databases (ACM D. Library, CINAHL, IEEE Xplore, PubMed, Web of Science) complemented with grey literature from Google Scholar. Studies using simulation models with system thinking to assess system performance in topics relevant to integrated healthcare were selected for revision. Results After screening 2274 articles, 30 were selected for analysis. Five modeling techniques were characterized, across four application areas in healthcare. Complexity was defined in nine aspects, embedded distinctively in each modeling technique. 'What if?' & 'How to?' scenarios were identified as methods for system optimization. The mean time frame for performance assessments was 18 years. Conclusions Simulation models can evaluate system performance emphasizing the complex relations between components, understanding the system's adaptability to change in short or long-term assessments. These advantages position them as a useful tool for complementing performance assessment of integrated healthcare systems in their pursuit of the 'Triple Aim'. Besides literacy in modeling techniques, accurate model selection is facilitated after identification and prioritization of the complexities that rule system performance. For this purpose, a tool for selecting the most appropriate simulation modeling techniques was developed.
1 citations
TL;DR: In this paper , the authors demonstrate how a network-based modelling and simulation approach utilizing generic modelling principles can quantify the extent to which the existing facilities in the public healthcare system can effectively cope with the forecasted COVID-19 caseload; and inform decisions on capacity at makeshift COVID19 Care Centres (CCC) to handle patient overflows.
Abstract: The COVID-19 pandemic has placed severe demands on healthcare facilities across the world, and in several countries, makeshift COVID-19 centres have been operationalised to handle patient overflow. In developing countries such as India, the public healthcare system (PHS) is organised as a hierarchical network with patient flows from lower-tier primary health centres (PHC) to mid-tier community health centres (CHC) and downstream to district hospitals (DH). In this study, we demonstrate how a network-based modelling and simulation approach utilising generic modelling principles can (a) quantify the extent to which the existing facilities in the PHS can effectively cope with the forecasted COVID-19 caseload; and (b) inform decisions on capacity at makeshift COVID-19 Care Centres (CCC) to handle patient overflows. We apply the approach to an empirical study of a local PHS comprising ten PHCs, three CHCs, one DH and one makeshift CCC. Our work demonstrates how the generic modelling approach finds extensive use in the development of simulations of multi-tier facility networks that may contain multiple instances of generic simulation models of facilities at each network tier. Further, our work demonstrates how multi-tier healthcare facility network simulations can be leveraged for capacity planning in health crises.
TL;DR: In this article , the authors present a synthesis of the literature on simulation modeling in OPD using two approaches: a bibliometric analysis (employing keyword co-occurrence network) and a literature classification focusing on OPD strategy, OPD performance measures, and simulation techniques.
Abstract: The increase in demand for outpatient departments (OPDs) has contributed to overcrowded clinics and patient dissatisfaction. Computer simulation can help decision-makers meet the operational challenge of balancing the demand for outpatient services with considerations of available capacity. The paper presents a synthesis of the literature on simulation modeling in OPD using two approaches: a bibliometric analysis (employing keyword co-occurrence network) and a literature classification focusing on OPD strategy, OPD performance measures, and simulation techniques. Our review is based on 161 papers, published between 2006 and 2020, identified through a methodological search of the literature. The objective of the review is threefold: (1) to identify the major and emerging research issues in general and specialized OPD, (2) to find the commonly used performance measures in OPD and how it is associated with the strategies used to improve the performance, and (3) to identify the commonly used simulation methods for OPD modeling. A key finding from the bibliometric analysis is that most OPD research can be classified under one of the four clusters—“organization and management,”“patient satisfaction,”“overbooking,” and “performance.” We also find that patient waiting time has received much attention among the performance measures reported in the literature, followed by server idle time/overtime (server here is the OPD consultant or other healthcare resource). Our review serves as a key reference point for scholars, practitioners, students, and healthcare stakeholders, and those who use quantitative tools to aid operational decision-making.
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TL;DR: An integrated and fresh look into the area of GrSCM is taken, using the rich body of available literature, including earlier reviews that had relatively limited perspectives, on the basis of the problem context in supply chain's major influential areas.
Abstract: Vol. 9 Issue 1 pp. 000‐000 There is a growing need for integrating environmentally sound choices into supply-chain management research and practice. Perusal of the literature shows that a broad frame of reference for green supply-chain management (GrSCM) is not adequately developed. Regulatory bodies that formulate regulations to meet societal and ecological concerns to facilitate growth of business and economy also suffer from its absence. A succinct classification to help academicians, researchers and practitioners in understanding integrated GrSCM from a wider perspective is needed. Further, sufficient literature is available to warrant such classification. This paper takes an integrated and fresh look into the area of GrSCM. The literature on GrSCM is covered exhaustively from its conceptualization, primarily taking a ‘reverse logistics angle’. Using the rich body of available literature, including earlier reviews that had relatively limited perspectives, the literature on GrSCM is classified on the basis of the problem context in supply chain’s major influential areas. It is also classified on the basis of methodology and approach adopted. Various mathematical tools/techniques used in literature vis-a-vis the contexts of GrSCM are mapped. A timeline indicating relevant papers is also provided as a ready reference. Finally, the findings and interpretations are summarized, and the main research issues and opportunities are highlighted.
3,344 citations
TL;DR: Following a comprehensive review of the literature, proposes a research agenda that focuses on the process of performance measurement system design, rather than the detail of specific measures.
Abstract: The importance of performance measurement has long been recognized by academics and practitioners from a variety of functional disciplines. Seeks to bring together this diverse body of knowledge into a coherent whole. To ensure that the key issues are identified, focuses on the process of performance measurement system design, rather than the detail of specific measures. Following a comprehensive review of the literature, proposes a research agenda.
3,290 citations
TL;DR: This paper provides a comprehensive survey of research on appointment scheduling in outpatient services and identifies future research directions that provide opportunities to expand existing knowledge and close the gap between theory and practice.
Abstract: This paper provides a comprehensive survey of research on appointment scheduling in outpatient services. Effective scheduling systems have the goal of matching demand with capacity so that resources are better utilized and patient waiting times are minimized. Our goal is to present general problem formulation and modeling considerations, and to provide taxonomy of methodologies used in previous literature. Current literature fails to develop generally applicable guidelines to design appointment systems, as most studies have suggested highly situation-specific solutions. We identify future research directions that provide opportunities to expand existing knowledge and close the gap between theory and practice.
928 citations
TL;DR: Simulation modelling is a powerful method for modelling both small and large populations to inform policy makers in the provision of health care and although the number of modelling papers has grown substantially over recent years, further research is required to assess the value of modelling.
Abstract: BACKGROUND: The objective of the review was to evaluate the extent, quality and value of computer simulation modelling in population health and health care delivery.
METHODS: A narrative systematic review was carried out of world literature from 1980 to 1999, searching Medline, INSPEC, Embase, HealthSTAR, Science Citation Index, CINAHL, MathSci, INFORMS Online and SIGLE databases, and researchers in the field were contacted. Papers were included if they contained a computer simulation model of individuals in a stochastic system and the topic or setting related to population health or health service delivery.
RESULTS: A total of 182 papers met the inclusion criteria. Simulation modelling has been undertaken in a wide range of health care topic areas, including hospital scheduling and organization, communicable disease, screening, costs of illness and economic evaluation. However, the quality of published papers was variable and few reported on the outcomes of implementation of models, so that the value of modelling could not be assessed.
CONCLUSION: Simulation modelling is a powerful method for modelling both small and large populations to inform policy makers in the provision of health care. It has been applied to a wide variety of health care problems. Although the number of modelling papers has grown substantially over recent years, further research is required to assess the value of modelling.
568 citations
TL;DR: This work discusses why specificity dominates and why more generic approaches are rare in the DES literature, and classify papers according to the areas of application evident in the literature, discussing the apparent lack of genericity.
Abstract: 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.
505 citations