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A system dynamics-based simulation study for managing clinical governance and pathways in a hospital / M. Maliapen in Journal of the operational research society (JORS), Vol. 61 N° 2 (Fevrier 2010) 

Public ISBD [article]  in Journal of the operational research society (JORS) > Vol. 61 N° 2 (Fevrier 2010) . - pp. 255–264 Titre : A system dynamics-based simulation study for managing clinical governance and pathways in a hospital Type de document : texte imprimé Auteurs : M. Maliapen, Auteur ; B. C. Dangerfield, Auteur Année de publication : 2011 Article en page(s) : pp. 255–264 Note générale : Recherche opérationnelle Langues : Anglais (eng) Mots-clés : Clinical  pathways  System  dynamics  Decision  support  system  Diagnostic-related  groups  (DRG) Index. décimale : 001.424 Résumé : This paper examines the development of clinical pathways (CP) in a hospital in Australia based on empirical clinical data of patient episodes. A system dynamics (SD)-based decision support system is developed and analysed for this purpose. The study highlights the scenarios that will help hospital administrators to redistribute caseloads among admitting clinicians with a focus on multiple diagnostic-related groups (DRGs) as the means to improve the patient turnaround and hospital throughput without compromising quality patient care. DRGs are the best known classification system used in a casemix funding model. Casemix is a DRG-based government funding model for hospitals with a mix of performance measures aiming to reward initiatives that increase efficiencies in hospitals. The classification system groups inpatient stays into clinically meaningful categories of similar levels of complexity that consume similar amounts of resources. Policy explorations reveal various combinations of the dominant policies that hospital management can adopt. With the use of visual interfaces, executives can manipulate the DSS to test various scenarios. Experimental evidence based on focus groups demonstrated that it can enhance group learning processes and improve decision making. The findings are supported by other recent studies of CP implementation on various DRGs. These showed substantial reduction in length of stay, costs and resource utilization. DEWEY : 001.424 ISSN : 0160-5682 En ligne : http://www.palgrave-journals.com/jors/journal/v61/n2/abs/jors2008134a.html [article] A system dynamics-based simulation study for managing clinical governance and pathways in a hospital [texte imprimé] / M. Maliapen, Auteur ; B. C. Dangerfield, Auteur . - 2011 . - pp. 255–264. Recherche opérationnelle Langues : Anglais (eng) in Journal of the operational research society (JORS) > Vol. 61 N° 2 (Fevrier 2010) . - pp. 255–264 Mots-clés : Clinical  pathways  System  dynamics  Decision  support  system  Diagnostic-related  groups  (DRG) Index. décimale : 001.424 Résumé : This paper examines the development of clinical pathways (CP) in a hospital in Australia based on empirical clinical data of patient episodes. A system dynamics (SD)-based decision support system is developed and analysed for this purpose. The study highlights the scenarios that will help hospital administrators to redistribute caseloads among admitting clinicians with a focus on multiple diagnostic-related groups (DRGs) as the means to improve the patient turnaround and hospital throughput without compromising quality patient care. DRGs are the best known classification system used in a casemix funding model. Casemix is a DRG-based government funding model for hospitals with a mix of performance measures aiming to reward initiatives that increase efficiencies in hospitals. The classification system groups inpatient stays into clinically meaningful categories of similar levels of complexity that consume similar amounts of resources. Policy explorations reveal various combinations of the dominant policies that hospital management can adopt. With the use of visual interfaces, executives can manipulate the DSS to test various scenarios. Experimental evidence based on focus groups demonstrated that it can enhance group learning processes and improve decision making. The findings are supported by other recent studies of CP implementation on various DRGs. These showed substantial reduction in length of stay, costs and resource utilization. DEWEY : 001.424 ISSN : 0160-5682 En ligne : http://www.palgrave-journals.com/jors/journal/v61/n2/abs/jors2008134a.html