Implementation of simulation modelling to improve service planning in specialist orthopaedic and neurosurgical outpatient services
Abstract Background Advanced physiotherapist-led services have been embedded in specialist orthopaedic and neurosurgical outpatient departments across Queensland, Australia, to ameliorate capacity constraints. Simulation modelling has been used to inform the optimal scale and professional mix of ser...
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| Format: | Article |
| Language: | English |
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BMC
2019-08-01
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| Series: | Implementation Science |
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| Online Access: | http://link.springer.com/article/10.1186/s13012-019-0923-1 |
| _version_ | 1818279739447574528 |
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| author | Nicole Moretto Tracy A. Comans Angela T. Chang Shaun P. O’Leary Sonya Osborne Hannah E. Carter David Smith Tania Cavanagh Dean Blond Maree Raymer |
| author_facet | Nicole Moretto Tracy A. Comans Angela T. Chang Shaun P. O’Leary Sonya Osborne Hannah E. Carter David Smith Tania Cavanagh Dean Blond Maree Raymer |
| author_sort | Nicole Moretto |
| collection | DOAJ |
| description | Abstract Background Advanced physiotherapist-led services have been embedded in specialist orthopaedic and neurosurgical outpatient departments across Queensland, Australia, to ameliorate capacity constraints. Simulation modelling has been used to inform the optimal scale and professional mix of services required to match patient demand. The context and the value of simulation modelling in service planning remain unclear. We aimed to examine the adoption, context and costs of using simulation modelling recommendations to inform service planning. Methods Using an implementation science approach, we undertook a prospective, qualitative evaluation to assess the use of discrete event simulation modelling recommendations for service re-design and to explore stakeholder perspectives about the role of simulation modelling in service planning. Five orthopaedic and neurosurgical services in Queensland, Australia, were selected to maximise variation in implementation effectiveness. We used the consolidated framework for implementation research (CFIR) to guide the facilitation and analysis of the stakeholder focus group discussions. We conducted a prospective costing analysis in each service to estimate the costs associated with using simulation modelling to inform service planning. Results Four of the five services demonstrated adoption by inclusion of modelling recommendations into proposals for service re-design. Four CFIR constructs distinguished and two CFIR constructs did not distinguish between high versus mixed implementation effectiveness. We identified additional constructs that did not map onto CFIR. The mean cost of implementation was AU$34,553 per site (standard deviation = AU$737). Conclusions To our knowledge, this is the first time the context of implementing simulation modelling recommendations in a health care setting, using a validated framework, has been examined. Our findings may provide valuable insights to increase the uptake of healthcare modelling recommendations in service planning. |
| first_indexed | 2024-12-12T23:38:07Z |
| format | Article |
| id | doaj.art-795341b4faba45e0a833c13a3c8bfc7c |
| institution | Directory Open Access Journal |
| issn | 1748-5908 |
| language | English |
| last_indexed | 2024-12-12T23:38:07Z |
| publishDate | 2019-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science |
| spelling | doaj.art-795341b4faba45e0a833c13a3c8bfc7c2022-12-22T00:07:19ZengBMCImplementation Science1748-59082019-08-0114111110.1186/s13012-019-0923-1Implementation of simulation modelling to improve service planning in specialist orthopaedic and neurosurgical outpatient servicesNicole Moretto0Tracy A. Comans1Angela T. Chang2Shaun P. O’Leary3Sonya Osborne4Hannah E. Carter5David Smith6Tania Cavanagh7Dean Blond8Maree Raymer9Centre for Health Services Research, Faculty of Medicine, The University of QueenslandCentre for Health Services Research, Faculty of Medicine, The University of QueenslandMetro North Hospital and Health Service, Royal Brisbane and Women’s HospitalMetro North Hospital and Health Service, Royal Brisbane and Women’s HospitalSchool of Nursing and Midwifery, Faculty of Health, Engineering and Sciences, University of Southern QueenslandAustralian Centre for Health Services Innovation, School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of TechnologyWest Moreton HealthCairns and Hinterland Hospital and Health ServiceGold Coast HealthMetro North Hospital and Health Service, Royal Brisbane and Women’s HospitalAbstract Background Advanced physiotherapist-led services have been embedded in specialist orthopaedic and neurosurgical outpatient departments across Queensland, Australia, to ameliorate capacity constraints. Simulation modelling has been used to inform the optimal scale and professional mix of services required to match patient demand. The context and the value of simulation modelling in service planning remain unclear. We aimed to examine the adoption, context and costs of using simulation modelling recommendations to inform service planning. Methods Using an implementation science approach, we undertook a prospective, qualitative evaluation to assess the use of discrete event simulation modelling recommendations for service re-design and to explore stakeholder perspectives about the role of simulation modelling in service planning. Five orthopaedic and neurosurgical services in Queensland, Australia, were selected to maximise variation in implementation effectiveness. We used the consolidated framework for implementation research (CFIR) to guide the facilitation and analysis of the stakeholder focus group discussions. We conducted a prospective costing analysis in each service to estimate the costs associated with using simulation modelling to inform service planning. Results Four of the five services demonstrated adoption by inclusion of modelling recommendations into proposals for service re-design. Four CFIR constructs distinguished and two CFIR constructs did not distinguish between high versus mixed implementation effectiveness. We identified additional constructs that did not map onto CFIR. The mean cost of implementation was AU$34,553 per site (standard deviation = AU$737). Conclusions To our knowledge, this is the first time the context of implementing simulation modelling recommendations in a health care setting, using a validated framework, has been examined. Our findings may provide valuable insights to increase the uptake of healthcare modelling recommendations in service planning.http://link.springer.com/article/10.1186/s13012-019-0923-1ImplementationDiscrete event simulationOrthopaedicsNeurosurgeryPhysiotherapyHospital |
| spellingShingle | Nicole Moretto Tracy A. Comans Angela T. Chang Shaun P. O’Leary Sonya Osborne Hannah E. Carter David Smith Tania Cavanagh Dean Blond Maree Raymer Implementation of simulation modelling to improve service planning in specialist orthopaedic and neurosurgical outpatient services Implementation Science Implementation Discrete event simulation Orthopaedics Neurosurgery Physiotherapy Hospital |
| title | Implementation of simulation modelling to improve service planning in specialist orthopaedic and neurosurgical outpatient services |
| title_full | Implementation of simulation modelling to improve service planning in specialist orthopaedic and neurosurgical outpatient services |
| title_fullStr | Implementation of simulation modelling to improve service planning in specialist orthopaedic and neurosurgical outpatient services |
| title_full_unstemmed | Implementation of simulation modelling to improve service planning in specialist orthopaedic and neurosurgical outpatient services |
| title_short | Implementation of simulation modelling to improve service planning in specialist orthopaedic and neurosurgical outpatient services |
| title_sort | implementation of simulation modelling to improve service planning in specialist orthopaedic and neurosurgical outpatient services |
| topic | Implementation Discrete event simulation Orthopaedics Neurosurgery Physiotherapy Hospital |
| url | http://link.springer.com/article/10.1186/s13012-019-0923-1 |
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