simulation for strategic planning – the scenariothe
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Simulation for Strategic Planning – the ScenarioPlanning the Scenario GeneratorPopulation Analysis Eventp yMarch 2009
Si l ti Vi t l P l tiSimulating a Virtual Population
Scenario Generator• Simulating a virtual population and disease g
related demand• Through care pathways• To understand the impact of population and
disease, and likely changes to the healthcare environment on expected activityenvironment on expected activity
• To test “what if” scenarios
What is Simulation?
A technique that aims to imitate abstract andA technique that aims to imitate, abstract and represent a system, process or behaviour for specific analytical, decision support or learning purposes
Simulation for strategic planning
Will it work?it’s too risky to test live Will it impact
elsewhere in t
How might demand
our systemchange over time?
What is the optimum cost
/ capacity trade off?
Modelof
care trade-off?care
Why simulate?
• It can help to take you beyond a process map into potential impacts of implementation
• It aids understanding of complex systems• You might discover unanticipated consequences of a plan• It should help to inform decisions
BUT• Simulation won’t tell you the answer, but it will help you ask
better questions• It will only be as good as the data you put in, but it will help
you make sense of that data• All models are wrong but some are useful• All models are wrong, but some are useful• It will not be an accurate predictor of events, but it might be
better to be “broadly right than precisely wrong”y g y g
Objectives of the ScenarioObjectives of the Scenario Generator
The ability to model scenarios based upon local population,The ability to model scenarios based upon local population,prevalence of disease and pathways of care, and to simulate their operation to:make more informed strategic decisions and planning choicesoptimise throughput, end-to-end transaction time, cost reduction and
ili iresource utilisationanticipate effects that changes to a particular model of care might
have upon a whole healthcare system and that might otherwise havehave upon a whole healthcare system and that might otherwise have been overlookedbetter understand the response of the health system to changes inbetter understand the response of the health system to changes in
population, disease prevalence, service capacity, configuration and demand
Functional model
Scenarios
PopulationDemographyPrevalence
Events
ScenariosReferral patternsCapacityDurationEvents
Mental Health
Duration
Population
Wholesystemmodel
Simulationresults
Urgent
Planned
Demographicweighting
MaternityPrevalence
Service points flows Pathway Constrainedpoints, flows
& waitsy
models resources
A C P h i S iA Care Pathway in Scenario Generator
Lambeth PopulationLambeth Population
Simulating Population Growth
• Scenarios can be modelled for population growthp p g• SG ages the population year on year adding births and taking away
deathsP j ti f ti ll i d i ti t b d ll d i• Projections function allows inward migration to be modelled in addition to natural population growth
• Changes to the health system care pathways can be modelled withinChanges to the health system care pathways can be modelled within same scenarios
• ….any number of “what if” scenarios
Lambeth Population Forecast –Population x prevalence + birthsPopulation x prevalence + births ‐ deaths
1 year run producing1 year run, producingactivity data
5 year run looking at possible growth in urgent admissions
What if Scenario
• 7% less primary care activity referred to7% less primary care activity referred to outpatients in year 2
• New population of 5000 arrives in year 3y
Baseline Scenario:Lambeth – 5 year forecastforecast
What if Scenario:Lambeth – 5 yearLambeth 5 year forecast
Primary Care DemandyLambeth – 5 year forecast
Costs Lambeth – 5 f tyear forecast
Results
• Simulation runs of up to 50 yearsSimulation runs of up to 50 years• Activity by step and across pathways (high level display) • CostsCosts• Constraints (queuing) overall and at multiple points in run• Waiting standard facility and breach reportingg y p g
Where is it being used?
Current uses…
The resource impact and capacity requirements of new models of care:
• population growth
t ti it l• testing capacity plans
• viability of existing hospital services as a result of shift to iprimary care
• care pathways (incl. falls, stroke, major trauma)
• remodelling unscheduled care
• admission avoidance/intermediate care• admission avoidance/intermediate care
• polyclinics
Link to Spatial Implications
• SG results expressed in terms of activity by individual pathway p y y p ysteps, and aggregated steps and costs (with inflation)
• Users need to be able to translate this into potential requirement for estates and workforceestates and workforce
• Currently developing work with UEL and HUDU to understand results in terms of spatial requirements
Define
Designinitial
Defineproblem
initialmodel
Selectapproaches
ValidateDevelopconcept Validateconcept
Doanalys
esDo otheranalyses
SimulateRefine
es
Consult
Drawconclusions
Act upon
outputsoutputs
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