Here’s something we prepared earlier: Development, use and reuse of a configurable, inter-disciplinary approach for tackling overcrowding in NHS hospitals
Crowe, S; Grieco, L; Monks, T; et al.Keogh, B; Penn, M; Clancy, M; Elkhodair, S; Vindrola-Padros, C; Fulop, NJ; Utley, M
Date: 18 April 2023
Article
Journal
Journal of the Operational Research Society
Publisher
Taylor & Francis
Publisher DOI
Abstract
Overcrowding affects hospital emergency departments (ED) worldwide. Most OR studies
addressing overcrowding develop bespoke models to explore potential improvements but
ignore the organisational context in which they would be implemented, and few influence
practice. There is interest in whether reusable models, for ED crowding and ...
Overcrowding affects hospital emergency departments (ED) worldwide. Most OR studies
addressing overcrowding develop bespoke models to explore potential improvements but
ignore the organisational context in which they would be implemented, and few influence
practice. There is interest in whether reusable models, for ED crowding and in healthcare
generally, could have more impact. We developed a configurable approach for tackling ED
overcrowding. A reusable queuing model for exploring drivers of ED performance was
augmented by a qualitative approach for exploring the implementation context and a generic
framework for assessing the likely compatibility of interventions with a given organisation.
At the hospital where the approach was developed it directly informed strategy. We describe
reuse of the approach at three hospitals. One project was completed and well-received by
hospital management, two were terminated partway when data problems surfaced. The
primary contribution of this work is its novelty in considering, alongside modelling,
evidence-based interventions to overcrowding and qualitative assessment of a hospital’s
aptitude and capability to adopt different interventions. A secondary contribution is to further
the debate on model reuse, in particular by introducing more complex, modelling-centred
approaches that acknowledge how models must relate to tangible interventions with
reasonable prospects of being adopted locally.
Health and Community Sciences
Faculty of Health and Life Sciences
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