Implementation of simulation modelling to improve service planning in specialist orthopaedic and neurosurgical outpatient services.
Costs
Discrete event simulation
Economic evaluation
Hospital
Implementation
Neurosurgery
Orthopaedics
Physiotherapy
Journal
Implementation science : IS
ISSN: 1748-5908
Titre abrégé: Implement Sci
Pays: England
ID NLM: 101258411
Informations de publication
Date de publication:
09 08 2019
09 08 2019
Historique:
received:
28
03
2019
accepted:
09
07
2019
entrez:
11
8
2019
pubmed:
11
8
2019
medline:
24
8
2019
Statut:
epublish
Résumé
Advanced physiotherapist-led services have been embedded in specialist orthopaedic and neurosurgical outpatient departments across Queensland, Australia, to ameliorate capacity constraints. Simulation modelling has been used to inform the optimal scale and professional mix of services required to match patient demand. The context and the value of simulation modelling in service planning remain unclear. We aimed to examine the adoption, context and costs of using simulation modelling recommendations to inform service planning. Using an implementation science approach, we undertook a prospective, qualitative evaluation to assess the use of discrete event simulation modelling recommendations for service re-design and to explore stakeholder perspectives about the role of simulation modelling in service planning. Five orthopaedic and neurosurgical services in Queensland, Australia, were selected to maximise variation in implementation effectiveness. We used the consolidated framework for implementation research (CFIR) to guide the facilitation and analysis of the stakeholder focus group discussions. We conducted a prospective costing analysis in each service to estimate the costs associated with using simulation modelling to inform service planning. Four of the five services demonstrated adoption by inclusion of modelling recommendations into proposals for service re-design. Four CFIR constructs distinguished and two CFIR constructs did not distinguish between high versus mixed implementation effectiveness. We identified additional constructs that did not map onto CFIR. The mean cost of implementation was AU$34,553 per site (standard deviation = AU$737). To our knowledge, this is the first time the context of implementing simulation modelling recommendations in a health care setting, using a validated framework, has been examined. Our findings may provide valuable insights to increase the uptake of healthcare modelling recommendations in service planning.
Sections du résumé
BACKGROUND
Advanced physiotherapist-led services have been embedded in specialist orthopaedic and neurosurgical outpatient departments across Queensland, Australia, to ameliorate capacity constraints. Simulation modelling has been used to inform the optimal scale and professional mix of services required to match patient demand. The context and the value of simulation modelling in service planning remain unclear. We aimed to examine the adoption, context and costs of using simulation modelling recommendations to inform service planning.
METHODS
Using an implementation science approach, we undertook a prospective, qualitative evaluation to assess the use of discrete event simulation modelling recommendations for service re-design and to explore stakeholder perspectives about the role of simulation modelling in service planning. Five orthopaedic and neurosurgical services in Queensland, Australia, were selected to maximise variation in implementation effectiveness. We used the consolidated framework for implementation research (CFIR) to guide the facilitation and analysis of the stakeholder focus group discussions. We conducted a prospective costing analysis in each service to estimate the costs associated with using simulation modelling to inform service planning.
RESULTS
Four of the five services demonstrated adoption by inclusion of modelling recommendations into proposals for service re-design. Four CFIR constructs distinguished and two CFIR constructs did not distinguish between high versus mixed implementation effectiveness. We identified additional constructs that did not map onto CFIR. The mean cost of implementation was AU$34,553 per site (standard deviation = AU$737).
CONCLUSIONS
To our knowledge, this is the first time the context of implementing simulation modelling recommendations in a health care setting, using a validated framework, has been examined. Our findings may provide valuable insights to increase the uptake of healthcare modelling recommendations in service planning.
Identifiants
pubmed: 31399105
doi: 10.1186/s13012-019-0923-1
pii: 10.1186/s13012-019-0923-1
pmc: PMC6688348
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
78Références
Eur J Health Econ. 2007 Jun;8(2):111-21
pubmed: 17347844
Clin Invest Med. 2005 Dec;28(6):312-5
pubmed: 16450620
Health Policy. 1997 Jun;40(3):199-215
pubmed: 10168752
J Oper Res Soc. 2011;62(8):1431-1451
pubmed: 32226177
Implement Sci. 2016 Dec 1;11(1):158
pubmed: 27906041
J Healthc Manag. 2013 Mar-Apr;58(2):110-24; discussion 124-5
pubmed: 23650696
Health Care Manag Sci. 2006 Feb;9(1):31-45
pubmed: 16613015
Value Health. 2015 Jan;18(1):5-16
pubmed: 25595229
Implement Sci. 2013 May 10;8:51
pubmed: 23663819
Implement Sci. 2014 Dec 18;9:168
pubmed: 25518730
Value Health. 2007 Jul-Aug;10(4):305-16
pubmed: 17645685
Pharmacoeconomics. 2017 Sep;35(9):937-949
pubmed: 28560492
Health Care Manag Sci. 2003 May;6(2):105-16
pubmed: 12733614
Appl Health Econ Health Policy. 2016 Aug;14(4):479-491
pubmed: 27116359
BMJ Qual Saf. 2016 Jan;25(1):38-45
pubmed: 26115667
Implement Sci. 2016 Jun 06;11(1):81
pubmed: 27268021
Stud Health Technol Inform. 2000;77:47-50
pubmed: 11187595
Qual Saf Health Care. 2007 Oct;16(5):382-6
pubmed: 17913781
Lancet. 2012 Dec 15;380(9859):2163-96
pubmed: 23245607
BMJ Open. 2017 Jun 6;7(5):e013869
pubmed: 28588107
Qual Manag Health Care. 2011 Jan-Mar;20(1):15-29
pubmed: 21192204
J Manag Med. 1996;10(6):50-8, 3
pubmed: 10538033
J Health Serv Res Policy. 2014 Oct;19(4):216-23
pubmed: 24819380
J Am Coll Cardiol. 2008 Dec 16;52(25):2119-26
pubmed: 19095128
Implement Sci. 2009 Aug 07;4:50
pubmed: 19664226
J Oper Res Soc. 1981 Sep;32(9):825-32
pubmed: 10252405
Ann R Coll Surg Engl. 2005 May;87(3):174-80
pubmed: 15901377
Adm Policy Ment Health. 2011 Mar;38(2):65-76
pubmed: 20957426
J Public Health Med. 2003 Dec;25(4):325-35
pubmed: 14747592