Development and application of simulation modelling for orthopaedic elective resource planning in England.
| Title: | Development and application of simulation modelling for orthopaedic elective resource planning in England. |
|---|---|
| Authors: | Harper A; University of Exeter Medical School, NIHR Applied Research Collaboration South West Peninsula, Exeter, UK a.l.harper@exeter.ac.uk.; University of Exeter Faculty of Health and Life Sciences, Exeter, UK.; Monks T; University of Exeter Medical School, NIHR Applied Research Collaboration South West Peninsula, Exeter, UK.; University of Exeter Faculty of Health and Life Sciences, Exeter, UK.; Wilson R; NIHR Applied Research Collaboration West, Bristol, UK.; Population Health Sciences, University of Bristol, Bristol, UK.; Redaniel MT; NIHR Applied Research Collaboration West, Bristol, UK.; Population Health Sciences, University of Bristol, Bristol, UK.; Eyles E; NIHR Applied Research Collaboration West, Bristol, UK.; Population Health Sciences, University of Bristol, Bristol, UK.; Jones T; NIHR Applied Research Collaboration West, Bristol, UK.; Population Health Sciences, University of Bristol, Bristol, UK.; Penfold C; NIHR Bristol Biomedical Research Centre, Bristol, UK.; University of Bristol, Bristol, UK.; Elliott A; North Bristol NHS Trust Southmead Hospital, Bristol, UK.; Keen T; North Bristol NHS Trust Southmead Hospital, Bristol, UK.; Pitt M; University of Exeter Medical School, NIHR Applied Research Collaboration South West Peninsula, Exeter, UK.; University of Exeter Faculty of Health and Life Sciences, Exeter, UK.; Blom A; The University of Sheffield, Sheffield, UK.; Whitehouse MR; North Bristol NHS Trust Southmead Hospital, Bristol, UK.; Judge A; NIHR Bristol Biomedical Research Centre, Bristol, UK.; University of Bristol, Bristol, UK. |
| Source: | BMJ open [BMJ Open] 2023 Dec 22; Vol. 13 (12), pp. e076221. Date of Electronic Publication: 2023 Dec 22. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [London] : BMJ Publishing Group Ltd, 2011- |
| MeSH Terms: | Orthopedics*; Humans ; State Medicine ; England ; Computer Simulation ; Elective Surgical Procedures |
| Abstract: | Objectives: This study aimed to develop a simulation model to support orthopaedic elective capacity planning.; Methods: An open-source, generalisable discrete-event simulation was developed, including a web-based application. The model used anonymised patient records between 2016 and 2019 of elective orthopaedic procedures from a National Health Service (NHS) Trust in England. In this paper, it is used to investigate scenarios including resourcing (beds and theatres) and productivity (lengths of stay, delayed discharges and theatre activity) to support planning for meeting new NHS targets aimed at reducing elective orthopaedic surgical backlogs in a proposed ring-fenced orthopaedic surgical facility. The simulation is interactive and intended for use by health service planners and clinicians.; Results: A higher number of beds (65-70) than the proposed number (40 beds) will be required if lengths of stay and delayed discharge rates remain unchanged. Reducing lengths of stay in line with national benchmarks reduces bed utilisation to an estimated 60%, allowing for additional theatre activity such as weekend working. Further, reducing the proportion of patients with a delayed discharge by 75% reduces bed utilisation to below 40%, even with weekend working. A range of other scenarios can also be investigated directly by NHS planners using the interactive web app.; Conclusions: The simulation model is intended to support capacity planning of orthopaedic elective services by identifying a balance of capacity across theatres and beds and predicting the impact of productivity measures on capacity requirements. It is applicable beyond the study site and can be adapted for other specialties.; (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.) |
| Competing Interests: | Competing interests: None declared. |
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| Contributed Indexing: | Keywords: Information management; ORTHOPAEDIC & TRAUMA SURGERY; Organisation of health services; Orthopaedic & trauma surgery; World Wide Web technology |
| Entry Date(s): | Date Created: 20231222 Date Completed: 20231225 Latest Revision: 20240124 |
| Update Code: | 20260130 |
| DOI: | 10.1136/bmjopen-2023-076221 |
| PMID: | 38135323 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't