Skip to main content
SpringerLink
Log in
Book cover

System Dynamics pp 391–415Cite as

Palgrave Macmillan

System Dynamics Mapping of Acute Patient Flows

  • Chapter
  • First Online:

Part of the book series: OR Essentials ((ORESS))

Abstract

Department of Health staff wished to use systems modelling to discuss acute patient flows with groups of NHS staff. The aim was to assess the usefulness of system dynamics (SD) in a healthcare context and to elicit proposals concerning ways of improving patient experience. Since time restrictions excluded simulation modelling, a hybrid approach using stock/flow symbols from SD was created. Initial interviews and hospital site visits generated a series of stock/flow maps. A ‘Conceptual Framework’ was then created to introduce the mapping symbols and to generate a series of questions about different patient paths and what might speed or slow patient flows. These materials formed the centre of three workshops for NHS staff. The participants were able to propose ideas for improving patient flows and the elicited data was subsequently employed to create a finalized suite of maps of a general acute hospital. The maps and ideas were communicated back to the Department of Health and subsequently assisted the work of the Modernization Agency.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   119.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   159.00
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Andersen DF and Richardson GP (1997). Scripts for group model building. Syst Dyn Rev 13: 107–129.

    Article  Google Scholar 

  • Ashton R, Hague L, Brandreth M, Worthington D and Cropper S (2005). A simulation-based study of a NHS walk-in centre. J Opl Res Soc 56: 153–161.

    Google Scholar 

  • Bennett JC and Worthington DJ (1998). An example of a good but partially successful OR engagement: Improving outpatient clinic operations. Interfaces 28(5): 56–69.

    Article  Google Scholar 

  • Bensley DC, Watson PC and Morrison GW (1995). Pathways of coronary care—A computer-simulation model of the potential for health gain. IMA J Math Appl Med Biol 12: 315–328.

    Article  Google Scholar 

  • Booth-Sweeney L and Sterman JD (2000). Bathtub dynamics: Initial results of a systems thinking inventory. Syst Dyn Rev 16: 249–286.

    Article  Google Scholar 

  • Bouyssou D, Forder R, Merchant S, Nance R, Pierskalla W, Roper M, Ryan D and van der Duyn Schouten F (2004). Review of Research Status of Operational Research in the UK. Swindon, UK: EPSRC/ESRC/ORS.

    Google Scholar 

  • Brailsford SC, Lattimer VA, Tarnaras P and Turnbull JC (2004). Emergency and on-demand health care: Modelling a large complex system. J Opl Res Soc 55: 34–42.

    Google Scholar 

  • Checkland PB (1995). Model validation in soft systems practice. Syst Res 12: 47–54.

    Article  Google Scholar 

  • Checkland PB (1996). Guidelines for the Use of ‘Soft Systems’ Methodology. Winchester: Information Management Group of the NHS Executive.

    Google Scholar 

  • Davies R and Bensley D (2005). Meeting health challenges with OR (special issue). J Opl Res Soc 56: 123–125.

    Google Scholar 

  • Davies R and Davies H (1994). Modelling patient flows and resource provision in health systems. Omega 22: 123–131.

    Article  Google Scholar 

  • Eden C (1987). Problem solving or problem finishing? In: Jackson MC and Keys P (eds). New Directions in Management Science. Aldershot, UK: Gower, pp 97–107.

    Google Scholar 

  • Eden C, Jones S, Sims D and Gunton H (1979). Images into models: The subjective world of the policy maker. Futures February: 11(1): 56–62.

    Google Scholar 

  • Eden C, Jones S and Sims D (1983). Messing About in Problems. Oxford: Pergamon Press.

    Google Scholar 

  • Forrester JW (1961). Industrial Dynamics. Cambridge, MA: MIT Press.

    Google Scholar 

  • Forrester JW (1968). Principles of Systems. Cambridge, MA: MIT Press.

    Google Scholar 

  • Forrester JW (1992). Policies, decisions and information sources for modelling. Eur J Opl Res 59: 42–63.

    Article  Google Scholar 

  • Forrester JW (1994). System dynamics, systems thinking, and soft OR. Syst Dyn Rev 10: 245–256.

    Article  Google Scholar 

  • Forrester JW and Senge PM (1980). Tests for building confidence in system dynamics models. In: Lagasto AA, Forrester JW and Lyneis JM (eds). System Dynamics: TIMS Studies in the Management Sciences. Oxford: North-Holland, pp 209–228.

    Google Scholar 

  • Frankfort-Nachmias C and Nachmias D (1992). Research Methods in the Social Sciences, 4th edn. London: Edward Arnold.

    Google Scholar 

  • Gallivan S, Utley M, Treasure T and Valencia O (2002). Booked inpatient admissions and hospital capacity: Mathematical modelling study. Br Med J 324: 280–282.

    Article  Google Scholar 

  • Griffiths JD, Price-Lloyd N, Smithies M and Williams JE (2005). Modelling the requirement for supplementary nurses in an intensive care unit. J Opl Res Soc 56: 126–133.

    Google Scholar 

  • Harper P and Shahani AK (2002). Modelling for the planning and management of bed capacities in hospitals. J Opl Res Soc 53: 11–18.

    Google Scholar 

  • Homer JB and Hirsch GB (2006). System dynamics modeling for public health: Background and opportunities. Am J Pub Health 96: 452–458.

    Article  Google Scholar 

  • Kleinmuntz DN (1993). Information processing and misperceptions of the implications of feedback in dynamic decision making. Syst Dyn Rev 9: 223–237.

    Article  Google Scholar 

  • Lane DC (1992). Modelling as learning: A consultancy methodology for enhancing learning in management teams. Eur J Opl Res 59: 64–84.

    Article  Google Scholar 

  • Lane DC (1998). Can we have confidence in generic structures? J Opl Res Soc 49: 936–947.

    Google Scholar 

  • Lane DC (2000). Diagramming conventions in system dynamics. J Opl Res Soc 51: 241–245.

    Google Scholar 

  • Lane DC (2008). The emergence and use of diagramming in system dynamics: A critical account. Syst Res Behavior Sci 25(1): forthcoming.

    Google Scholar 

  • Lane DC, Monefeldt C and Husemann E (2003). Client involvement in simulation model building: Hints and insights form a case study in a London hospital. Health Care Mngt Sci 6: 105–116.

    Article  Google Scholar 

  • Lane DC, Monefeldt C and Rosenhead JV (1998). Emergency—but no accident—a system dynamics study of an accident and emergency department. OR Insight 11(4): 2–10.

    Article  Google Scholar 

  • Lane DC, Monefeldt C and Rosenhead JV (2000). Looking in the wrong place for healthcare improvements: A system dynamics study of an accident and emergency department. J Opl Res Soc 51: 518–531.

    Google Scholar 

  • Leischow SJ and Milstein B (2006). Editorial: Systems thinking and modeling for public health practice. Am J Pub Health 96: 403–405.

    Article  Google Scholar 

  • Millard PH and McClean SI (eds) (1996). Go with the Flow: A Systems Approach to Healthcare Planning. London: Royal Society of Medicine Press.

    Google Scholar 

  • Moxnes E (1998). Not only the tragedy of the commons: Misperceptions of bioeconomics. Mngt Sci 44: 1234–1248.

    Article  Google Scholar 

  • Pidd M (1992). Computer Simulation in Management Science, 3rd ed. Chichester: Wiley.

    Google Scholar 

  • Pratt J, Gordon P and Plamping D (1999). Working Whole Systems: Putting Theory into Practice in Organisations. London: King’s Fund.

    Google Scholar 

  • Richardson GP (1986). Problems with casual-loop diagrams (originally published in 1976). Syst Dyn Rev 2: 158–170.

    Article  Google Scholar 

  • Richmond B (1994). Systems thinking/system dynamics: Let’s just get on with it. Syst Dyn Rev 10: 135–157.

    Article  Google Scholar 

  • Rosenhead J (ed) (1989). Rational Analysis for a Problematic World: Problem Structuring Methods for Complexity, Uncertainty and Conflict. Chichester: Wiley.

    Google Scholar 

  • Royston G (2005). Modelling and simulation in health: Potential, achievement and challenge. Presentation at the MASHnet launch event, WBS, 20 September.

    Google Scholar 

  • Royston G, Dost A, Townshend J and Turner H (1999). Using system dynamics to help develop and implement policies and programmes in health care in England. Syst Dyn Rev 15: 293–313.

    Article  Google Scholar 

  • Senge PM (1990). The Fifth Discipline: The Art and Practice of the Learning Organization. New York: Doubleday/Currency.

    Google Scholar 

  • Sterman JD (1989). Modelling managerial behaviour: Misperceptions of feedback in a dynamic decision making experiment. Mngt Sci 35: 321–339.

    Article  Google Scholar 

  • Sterman JD (1994a). Beyond training wheels. In: Senge PM, Roberts C, Ross R, Smith B and Kleiner A (eds). The Fifth Discipline Fieldbook. London: Nicholas Brealey Publishing, pp 177–184.

    Google Scholar 

  • Sterman JD (1994b). Learning in and about complex systems. Syst Dyn Rev 10: 291–330.

    Article  Google Scholar 

  • Sterman JD (2006). Learning from evidence in a complex world. Am J Pub Health 96: 505–514.

    Article  Google Scholar 

  • Vennix JAM (1996). Group Model-building: Facilitating Team Learning Using System Dynamics. Chichester: Wiley.

    Google Scholar 

  • Vennix JAM and Gubbels JW (1992). Knowledge elicitation in conceptual model building: A case study in modeling a regional Dutch health care system. Eur J Opl Res 59: 85–101.

    Article  Google Scholar 

  • Warren K (2004). Why has feedback systems thinking struggled to influence strategy and policy formulation? Suggestive evidence explanations and solutions. Syst Res Behav Sci 21: 331–347.

    Article  Google Scholar 

  • Wernerfelt B (1984). A resource-based view of the firm. Strat Mngt J 5: 171–180.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Henley Business School, University of Reading, Reading, London, UK

    D. C. Lane

  2. London School of Economics, London, UK

    D. C. Lane & E. Husemann

Authors
  1. D. C. Lane
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. Husemann
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Warwick Business School, University of Warwick, Warwick, United Kingdom

    Martin Kunc

Copyright information

© 2018 The Author(s)

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Lane, D.C., Husemann, E. (2018). System Dynamics Mapping of Acute Patient Flows. In: Kunc, M. (eds) System Dynamics. OR Essentials. Palgrave Macmillan, London. https://doi.org/10.1057/978-1-349-95257-1_13

Download citation

Publish with us

Policies and ethics

Search

Navigation