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The DH Accident and Emergency Department model: a national generic model used locally

Author

Listed:
  • A Fletcher

    (Department of Health)

  • D Halsall

    (Department of Health)

  • S Huxham

    (Department of Health)

  • D Worthington

    (Lancaster University)

Abstract

The Department of Health (DH) Accident and Emergency (A&E) simulation model was developed by Operational Research analysts within DH to inform the national policy team of significant barriers to the national target, for England, that 98% of all A&E attendances are to be completed (discharged, transferred or admitted) within 4 hours of arrival by December 2004. This paper discusses why the model was developed, the structure of the model, and the impact when used to inform national policy development. The model was then used as a consultancy tool to aid struggling hospital trusts to improve their A&E departments. The paper discusses these experiences with particular reference to the challenges of using a ‘generic’ national model for ‘specific’ local use.

Suggested Citation

  • A Fletcher & D Halsall & S Huxham & D Worthington, 2007. "The DH Accident and Emergency Department model: a national generic model used locally," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 58(12), pages 1554-1562, December.
    • Handle: RePEc:pal:jorsoc:v:58:y:2007:i:12:d:10.1057_palgrave.jors.2602344
    DOI: 10.1057/palgrave.jors.2602344
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    References listed on IDEAS

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    1. D C Lane & C Monefeldt & J V Rosenhead, 2000. "Looking in the wrong place for healthcare improvements: A system dynamics study of an accident and emergency department," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 51(5), pages 518-531, May.
    2. J B Jun & S H Jacobson & J R Swisher, 1999. "Application of discrete-event simulation in health care clinics: A survey," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 50(2), pages 109-123, February.
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    Cited by:

    1. Boyle, Laura M. & Marshall, Adele H. & Mackay, Mark, 2022. "A framework for developing generalisable discrete event simulation models of hospital emergency departments," European Journal of Operational Research, Elsevier, vol. 302(1), pages 337-347.
    2. Monks, Thomas & Robinson, Stewart & Kotiadis, Kathy, 2014. "Learning from discrete-event simulation: Exploring the high involvement hypothesis," European Journal of Operational Research, Elsevier, vol. 235(1), pages 195-205.
    3. Maria Di Mascolo & Alexia Gouin, 2013. "A generic simulation model to assess the performance of sterilization services in health establishments," Health Care Management Science, Springer, vol. 16(1), pages 45-61, March.
    4. D Worthington, 2009. "Reflections on queue modelling from the last 50 years," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 60(1), pages 83-92, May.
    5. M Pidd, 2010. "Why modelling and model use matter," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 61(1), pages 14-24, January.
    6. Gogi, Anastasia & Tako, Antuela A. & Robinson, Stewart, 2016. "An experimental investigation into the role of simulation models in generating insights," European Journal of Operational Research, Elsevier, vol. 249(3), pages 931-944.
    7. P R Harper & N H Powell & J E Williams, 2010. "Modelling the size and skill-mix of hospital nursing teams," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 61(5), pages 768-779, May.
    8. G Royston, 2009. "One hundred years of Operational Research in Health—UK 1948–2048," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 60(1), pages 169-179, May.
    9. Brailsford, Sally & Vissers, Jan, 2011. "OR in healthcare: A European perspective," European Journal of Operational Research, Elsevier, vol. 212(2), pages 223-234, July.
    10. H Pilgrim & P Tappenden & J Chilcott & M Bending & P Trueman & A Shorthouse & J Tappenden, 2009. "The costs and benefits of bowel cancer service developments using discrete event simulation," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 60(10), pages 1305-1314, October.
    11. Adrian Fletcher & Dave Worthington, 2009. "What is a ‘generic’ hospital model?—a comparison of ‘generic’ and ‘specific’ hospital models of emergency patient flows," Health Care Management Science, Springer, vol. 12(4), pages 374-391, December.

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