Causal study of low stakeholder engagement in healthcare simulation projects

Stakeholder engagement plays a fundamental role in the success of ‘operational research’ initiatives including simulation projects. However, there is little empirical evidence of real engagement in the context of healthcare simulation. This paper principally examines this issue and aims to provide insights into the possible causes. The paper reports on the results of a literature review and 10 field studies within the UK healthcare settings, supplemented with the authors’ experience in order to arrive at an initial list of the causes, which will then be tested through a survey of expert opinions. Twelve primary and 26 secondary causal factors, which received statistically significant level of agreement from the experts, are presented in a fish-bone diagram. The findings indicate that communication gap between simulation and stakeholder groups is the top primary factor contributing the most to the poor stakeholder engagement in healthcare simulation projects, followed by ‘poor management support’, ‘clinician’s high workload’ and ‘failure in producing tangible and quick results’.

[1]  S. D. Roberts,et al.  Cost-effective care of end-stage renal disease: a billion dollar question. , 1980, Annals of internal medicine.

[2]  Paul R. Harper,et al.  On the challenges of healthcare modelling and a proposed project life cycle for successful implementation , 2004, J. Oper. Res. Soc..

[3]  Tillal Eldabi,et al.  A rapid review method for extremely large corpora of literature: Applications to the domains of modelling, simulation, and management , 2011, Int. J. Inf. Manag..

[4]  Julie C. Lowery,et al.  Barriers to implementing simulation in health care , 1994, Proceedings of Winter Simulation Conference.

[5]  Morteza Shokri-Ghasabeh,et al.  Generic Project Success and Project Management Success Criteria and Factors: Literature Review and Survey , 2009 .

[6]  Michael Brennan,et al.  Reducing Flight Delays Through Better Traffic Management , 2009, Interfaces.

[7]  P. Plsek,et al.  The challenge of complexity in health care , 2001, BMJ : British Medical Journal.

[8]  Sally Brailsford,et al.  Overcoming the barriers to implementation of operations research simulation models in healthcare. , 2005, Clinical and investigative medicine. Medecine clinique et experimentale.

[9]  Sally I. McClean,et al.  A modeling framework that combines markov models and discrete-event simulation for stroke patient care , 2011, TOMC.

[10]  Michael Pidd,et al.  Simulation modelling is 50! Do we need a reality check? , 2009, J. Oper. Res. Soc..

[11]  Robert E. Levasseur People Skills: Marketing OR/MS - A People Problem , 2007, Interfaces.

[12]  Mariëlle den Hengst,et al.  Collaborative Business Engineering: A Decade of Lessons from the Field , 2004, J. Manag. Inf. Syst..

[13]  Simon J. E. Taylor,et al.  Economics of modeling and simulation: Reflections and implications for healthcare , 2010, Proceedings of the 2010 Winter Simulation Conference.

[14]  Michael Pidd,et al.  Provider and customer expectations of successful simulation projects , 1998, J. Oper. Res. Soc..

[15]  Gertrude P. Pannirselvam,et al.  Operations management research: an update for the 1990s , 1999 .

[16]  D. Swinglehurst,et al.  Tensions and paradoxes in electronic patient record research: a systematic literature review using the meta-narrative method. , 2009, The Milbank quarterly.

[17]  Vlatka Hlupic,et al.  Successful Simulation: A Practical Approach to Simulation Projects , 1995 .

[18]  Martijn Eskinasi,et al.  Lessons learned from unsuccessful modelling interventions , 2006 .

[19]  Sally C. Brailsford,et al.  Stakeholder engagement in health care simulation , 2009, Proceedings of the 2009 Winter Simulation Conference (WSC).

[20]  Brian W. Hollocks,et al.  Discrete-event simulation: an inquiry into user practice , 2001, Simul. Pract. Theory.

[21]  Jane Coughlan,et al.  Simulating the use of re-prioritisation as a wait-reduction strategy in an emergency department , 2010, Emergency Medicine Journal.

[22]  Robert E. Levasseur People Skills: Ensuring Project Success - A Change Management Perspective , 2010, Interfaces.

[23]  T. Greenhalgh,et al.  Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources , 2005, BMJ : British Medical Journal.

[24]  Tillal Eldabi,et al.  Simulation in manufacturing and business: A review , 2010, Eur. J. Oper. Res..

[25]  Joseph G. Voelkel,et al.  Guide to Quality Control , 1982 .

[26]  Tillal Eldabi,et al.  Integrated care development using systems modelling - A case study of intermediate care , 2011, Proceedings of the 2011 Winter Simulation Conference (WSC).

[27]  N Melão,et al.  Use of business process simulation: A survey of practitioners , 2003, J. Oper. Res. Soc..

[28]  Stephen P. Murphy,et al.  Successes and failures in UK/US development of simulation , 2002, Simul. Pract. Theory.

[29]  Christophe André,et al.  Health Status Determinants: Lifestyle, Environment, Health Care Resources and Efficiency , 2010 .

[30]  Robert Fildes,et al.  Success and survival of operational research groups—A review , 1997 .

[31]  Yogesh Deshpande,et al.  Verification and validation and complex environments: a study in service sector , 1998, 1998 Winter Simulation Conference. Proceedings (Cat. No.98CH36274).

[32]  Tillal Eldabi,et al.  Implementation issues of modeling healthcare problems: Misconceptions and lessons , 2009, Proceedings of the 2009 Winter Simulation Conference (WSC).

[33]  Martin Pitt,et al.  An analysis of the academic literature on simulation and modelling in health care , 2009, J. Simulation.

[34]  Paul R. Harper,et al.  Simulation in health-care: lessons from other sectors , 2012, Oper. Res..

[35]  G. Bevan,et al.  "Systematic" , 1966, Comput. J..