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OR and the challenge to improve the NHS: modelling for insight and improvement in in-patient flows

Author

Listed:
  • N C Proudlove

    (University of Manchester)

  • S Black

    (PA Consulting)

  • A Fletcher

    (Department of Health)

Abstract

This paper considers efforts to improve in-patient flows, a particularly urgent issue in the National Health Service (NHS). The context is described and related to reasons why OR has been making relatively little contribution. The paper argues that large complex models may often be unnecessary and even get in the way of providing clear insight and guidance for problem owners. The importance of understanding the generic working of systems to lead to improvement, and the limitations of simply describing them, is stressed. It is demonstrated that some very simple models can be of significant practical value in understanding and managing complex systems, changing mindsets and driving collection and use of operationally valuable data. Recommendations for more effective engagement with the NHS are offered.

Suggested Citation

  • N C Proudlove & S Black & A Fletcher, 2007. "OR and the challenge to improve the NHS: modelling for insight and improvement in in-patient flows," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 58(2), pages 145-158, February.
    • Handle: RePEc:pal:jorsoc:v:58:y:2007:i:2:d:10.1057_palgrave.jors.2602252
    DOI: 10.1057/palgrave.jors.2602252
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    References listed on IDEAS

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    1. P R Harper & M A Pitt, 2004. "On the challenges of healthcare modelling and a proposed project life cycle for successful implementation," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 55(6), pages 657-661, June.
    2. F Gorunescu & S I McClean & P H Millard, 2002. "A queueing model for bed-occupancy management and planning of hospitals," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 53(1), pages 19-24, January.
    3. E. El‐Darzi & C. Vasilakis & T. Chaussalet & P.H. Millard, 1998. "A simulation modelling approach to evaluating length of stay, occupancy, emptiness and bed blocking in a hospital geriatric department," Health Care Management Science, Springer, vol. 1(2), pages 143-149, October.
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    5. P R Harper & A K Shahani, 2002. "Modelling for the planning and management of bed capacities in hospitals," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 53(1), pages 11-18, January.
    6. C Vasilakis & A H Marshall, 2005. "Modelling nationwide hospital length of stay: opening the black box," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 56(7), pages 862-869, July.
    Full references (including those not matched with items on IDEAS)

    Citations

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    Cited by:

    1. J Bowers, 2010. "Waiting list behaviour and the consequences for NHS targets," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 61(2), pages 246-254, February.
    2. Oddoye, J.P. & Jones, D.F. & Tamiz, M. & Schmidt, P., 2009. "Combining simulation and goal programming for healthcare planning in a medical assessment unit," European Journal of Operational Research, Elsevier, vol. 193(1), pages 250-261, February.
    3. Baril, Chantal & Gascon, Viviane & Miller, Jonathan & Côté, Nadine, 2016. "Use of a discrete-event simulation in a Kaizen event: A case study in healthcare," European Journal of Operational Research, Elsevier, vol. 249(1), pages 327-339.
    4. 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.
    5. Chong Pan & Dali Zhang & Audrey Kon & Charity Wai & Woo Ang, 2015. "Patient flow improvement for an ophthalmic specialist outpatient clinic with aid of discrete event simulation and design of experiment," Health Care Management Science, Springer, vol. 18(2), pages 137-155, June.
    6. 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.
    7. 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.
    8. M N Jalil & R A Zuidwijk & M Fleischmann & Jo A E E van Nunen, 2011. "Spare parts logistics and installed base information," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 62(3), pages 442-457, March.
    9. Robinson, Stewart & Radnor, Zoe J. & Burgess, Nicola & Worthington, Claire, 2012. "SimLean: Utilising simulation in the implementation of lean in healthcare," European Journal of Operational Research, Elsevier, vol. 219(1), pages 188-197.
    10. Brailsford, Sally & Vissers, Jan, 2011. "OR in healthcare: A European perspective," European Journal of Operational Research, Elsevier, vol. 212(2), pages 223-234, July.
    11. Proudlove, N.C. & Bisogno, S. & Onggo, B.S.S. & Calabrese, A. & Levialdi Ghiron, N., 2017. "Towards fully-facilitated discrete event simulation modelling: Addressing the model coding stage," European Journal of Operational Research, Elsevier, vol. 263(2), pages 583-595.

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