Abstract
This Chapter describes the persistent issue in health care delivery of delayed hospital discharges, its proposed solutions and the contribution of system dynamics modelling to clarify the problem and provide insights. Two models are described which are typical of the many studies carried out by the authors on this subject.
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Notes
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Summary of the rules for drawing feedback loops:
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Balancing (B) (or negative) feedback loops are target seeking control loops and have just one or an odd number of negative links between variables.
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Reinforcing (R) (or positive) feedback loops are growth loops and have all or an even number of negative links between variables.
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Positive links are when an increase in a tail variable of a link gives rise causally to an increase in the head variable (and vice versa).
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Negative links are when an increase in the tail variable of a link gives rise causally to a decrease in the head variable (and vice versa).
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References
Age UK Press release 9/7/2018.
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Kings Fund/Nuffield Trust. (2017). The autumn budget: Joint statement on health and social care. Nuffield Trust, Health Foundation, Kings Fund.
National Audit Office Annual Report. (2016).
NHS England. (2016). Better care operating guide. NHS England.
Wolstenholme, E. F. (1999). A patient flow perspective of UK health service. System Dynamics Review, 15(3), 253–273.
Wolstenholme, E. F., Monk, D., & McKelvie, D. (2008). Influencing and interpreting health and social care policy in the UK. In H. Qudrat-Ullah, M. J. Spector, & P. I. Davidsen (Eds.), Complex decision making: Theory and practice (pp. 155–185). US: Springer-Verlag.
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Wolstenholme, E., McKelvie, D. (2019). Hospital Delayed Transfer of Care (Delayed Discharges). In: The Dynamics of Care. Springer, Cham. https://doi.org/10.1007/978-3-030-21878-2_7
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DOI: https://doi.org/10.1007/978-3-030-21878-2_7
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