Towards a Dynamic Theory of How Hospitals Cope in Times of High Demand

  • Eric WolstenholmeEmail author
  • Douglas McKelvie


This chapter builds on the research on delayed hospital discharge modelling work described in Chap. 7. It proposes a general, dynamic, hypothesis that the ‘normal’ mode of operation for many hospitals today is often well beyond their safe design capacity. This can be very risky for patients as well as expensive. A range of informal strategies which hospitals adopt to help cope with high demand are set out, together with their unintended consequences. These strategies and their unintended consequences are described in terms of the feedback loops and system archetypes introduced in Chap. 5. It is postulated that the unintended consequences for patients, staff and productivity result in an underachievement of the planned number and quality of hospital interventions. Moreover, the costs of using such coping strategies for lengthy periods could be much greater than the investment needed to avoid their use in the first place.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Symmetric ScenariosEdinburghUK
  2. 2.Symmetric ScenariosEdinburghUK

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