A system dynamics-based simulation study for managing clinical governance and pathways in a hospital

M Maliapen and B C Dangerfield ()
Additional contact information
M Maliapen: University of Central Lancashire
B C Dangerfield: University of Salford

Journal of the Operational Research Society, 2010, vol. 61, issue 2, 255-264

Abstract: Abstract 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.

Keywords: clinical pathways; system dynamics; decision support system; diagnostic-related groups (DRG) (search for similar items in EconPapers)
Date: 2010
References: View complete reference list from CitEc
Citations: View citations in EconPapers (5)

Downloads: (external link)
http://link.springer.com/10.1057/jors.2008.134 Abstract (text/html)
Access to full text is restricted to subscribers.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:pal:jorsoc:v:61:y:2010:i:2:d:10.1057_jors.2008.134

Ordering information: This journal article can be ordered from
http://www.springer. ... search/journal/41274

DOI: 10.1057/jors.2008.134

Access Statistics for this article

Journal of the Operational Research Society is currently edited by Tom Archibald and Jonathan Crook

More articles in Journal of the Operational Research Society from Palgrave Macmillan, The OR Society
Bibliographic data for series maintained by Sonal Shukla () and Springer Nature Abstracting and Indexing ().