Facing Implementation Barriers to Healthcare Simulation Studies

Implementation barriers to simulation studies are a reality in today's healthcare organizations. This work proposes a novel framework to use simulation to maximise successful implementation by (1) framing the right problem to face; (2) using what-if scenarios as an exploration tool for users’ value; (3) supporting knowledge integration in giving tangible results to discuss among different professionals. We successfully tested the framework in an 18-month Emergency Department overcrowding case study, by developing a Discrete Events Simulation model and using it as a decision making tool for a multi-disciplinary group of 21 professionals (doctors, nurses, aid nurses, hospital management and engineers expert in simulation). Results show that the framework helps finding the most implementable solutions in the context of study, under the rationale that a small implemented improvement is preferable than a big one on paper. In the presented case study, after 15 years of absence of organisational change, the hospital was able to implement three new simulated solutions in 18 months.