Operational Modelling
The Operational Modelling project involves the use of system dynamics (a methodology that helps understand complex feedback systems over time) to study the common and chronic operational problem of patients boarding in the emergency department (ED) who have been admitted to hospital. Our operational modelling at TGH:
The major goal of the project is to provide awareness to clinicians and hospital management that well-intended decisions likely have unintentional side effects and therefore sustainable improvements in chronic operational problems require thoughtful system-wide consideration.
The project has empowered clinicians and hospital managers to move forward from a better understanding of the ED-GIM problem to taking action in redesigning upstream and downstream strategies to improve hospital patient flow.
The next steps involve applying the same research questions to other inpatient services of other hospitals (teaching and community) in a city, region or entire country, as we would like to make our findings more generalizable.
Publications
Wong HJ, Wu RC, Caesar M, Abrams H and Morra D. Smoothing inpatient discharges decreases emergency department congestion: a system dynamics simulation model. Emergency Medicine Journal. 2010; In Press.
Wong HJ, Morra D, Caesar M, Carter MW and Abrams H. Understanding hospital and emergency department congestion: an examination of inpatient admission trends and bed resources. Canadian Journal of Emergency Medicine. 2010 Jan; 12(1):18-26.
Wong HJ, Wu RC, Tomlinson G, Caesar M, Abrams H, Carter MW and Morra D. How much do operational processes affect hospital inpatient discharge rates? Journal of Public Health. 2009 Dec; 31(4): 546-53.