System Dynamics Simulation of Hospital Resource Relocation for Healthcare Decision-making

Abstract: INTRODUCTION: Relocating hospital resources can change the efficiency of their use. The focus of this thesis is on non-emergency healthcare, specifically the relocation of staff and facilities. Relocation can be both time-consuming and costly. Predicting the expected outcome of a relocation is therefore important to determine whether the relocation is expected to have a positive or negative result. This prediction is done using a simulation model consisting of the relevant factors for hospitals. OBJECTIVES: The overall objective of this thesis is to develop a simulation model that can be used by hospital decision-makers to give them better insight into the potential outcomes of the relocation of resources. However, the most suitable model for the task first needs to be determined. Then the structure and accuracy of the model must be validated. METHODS: The thesis follows a design science methodology to aid in the development of the simulation model. With the chosen design science methodology the problem is identified; the objectives to solve it are defined; an artifact is designed, demonstrated, and evaluated; and finally, the results are communicated. RESULTS: The developed System Dynamics model can be used to assess the impact of non emergency hospital resource relocation. The user can change parameter values and get a real-time response of the expected effects the changes have on the outcome of the relocation. The model consists of four components: quality of care, staff satisfaction, patient satisfaction, and cost. These handle everything from the staff’s adaption to their new workplace, training of new staff, calculating the flow of patients in the hospital, etc. A fictive scenario based on real-world historical data isused to illustrate the use of the model and how to interpret its result. CONCLUSION: Through comparison of different simulation paradigms it is concluded that System Dynamics is the most suitable for non-emergency hospital resource relocation of staff and facilities. The developed System Dynamics model is a tool healthcare decision-makers can use to estimate the effects of their plans to relocate hospital resources. The developed model is flexible in its weight of the impacts certain parameters shall have, which makes it easier to adapt to the needs of the user. It also gives the user a responsibility to make sure that their use of the model is correct for their case. FUTURE WORK: Future work could include studying how the developed model could affect decisions in real healthcare systems. The model could also be extended to include more parameters, to manage to capture more complex behaviors.