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Using the Statecharts paradigm for simulation of patient flow in surgical care

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Abstract

Computer simulation of patient flow has been used extensively to assess the impacts of changes in the management of surgical care. However, little research is available on the utility of existing modeling techniques. The purpose of this paper is to examine the capacity of Statecharts, a system of graphical specification, for constructing a discrete-event simulation model of the peri-operative process. The Statecharts specification paradigm was originally developed for representing reactive systems by extending the formalism of finite-state machines through notions of hierarchy, parallelism, and event broadcasting. Hierarchy permits subordination between states so that one state may contain other states. Parallelism permits more than one state to be active at any given time. Broadcasting of events allows one state to detect changes in another state. In the context of the peri-operative process, hierarchy provides the means to describe steps within activities and to cluster related activities, parallelism provides the means to specify concurrent activities, and event broadcasting provides the means to trigger a series of actions in one activity according to transitions that occur in another activity. Combined with hierarchy and parallelism, event broadcasting offers a convenient way to describe the interaction of concurrent activities. We applied the Statecharts formalism to describe the progress of individual patients through surgical care as a series of asynchronous updates in patient records generated in reaction to events produced by parallel finite-state machines representing concurrent clinical and managerial activities. We conclude that Statecharts capture successfully the behavioral aspects of surgical care delivery by specifying permissible chronology of events, conditions, and actions.

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Authors and Affiliations

  1. Department of Health Care and Epidemiology, University of British Columbia, 620-1081 Burrard Street, Vancouver, V6Z 1Y6, Canada

    Boris Sobolev & Adrian Levy

  2. Department of Computer Science and Applied Mathematics, The Weizmann Institute of Science, Rehovot, 76100, Israel

    David Harel

  3. Clinical Operational Research Unit, University College London, 4 Taviton Street, WC1H 1BT, London, UK

    Christos Vasilakis

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  1. Boris Sobolev
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  2. David Harel
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  3. Christos Vasilakis
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  4. Adrian Levy
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Correspondence to Boris Sobolev.

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Sobolev, B., Harel, D., Vasilakis, C. et al. Using the Statecharts paradigm for simulation of patient flow in surgical care. Health Care Manage Sci 11, 79–86 (2008). https://doi.org/10.1007/s10729-007-9026-7

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  • DOI: https://doi.org/10.1007/s10729-007-9026-7

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