A new approach to getting simulation models used in healthcare: an example from emergency care

While simulation is routinely used by practitioners in many sectors, it is still not part of the hospital manager’s standard toolkit. One of the barriers to adoption often described is lack of trust: people trust models that they were involved in developing, but not necessarily those developed for other hospitals, no matter how similar. However, generic models designed to be applicable anywhere also face challenges, as potential users may distrust this one-size-fits-all approach. This paper presents a new approach to tackling this problem. Initially a “semi-generic” model is developed, namely a model that is applicable to a small group of hospitals that have some particular feature in common, e.g., geographical location/size. The semi-generic version is then tested extensively with stakeholders, first from within the initial group of hospitals and later from outside it. Finally, based on feedback from all the stakeholders, the model is adapted to make it fully generic, i.e., applicable to any hospital. The approach is illustrated by a system dynamics model which allows users to test the system-wide impact of five evidence-based interventions for older people in hospital Emergency Departments. Initially developed for one specific region, the fully generic version can be used anywhere in England.