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Patient Pathway Modelling Using Discrete Event Simulation to Improve the Management of COPD

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@article{509e5d7f1f07472dbd7bee3653fbbc4a,
title = "Patient Pathway Modelling Using Discrete Event Simulation to Improve the Management of COPD",
abstract = "The number of people affected by chronic obstructive pulmonary disease (COPD) is increasing and the hospital readmission rate is remarkably high. Therefore, healthcare professionals and managers have financial and workforce-related pressures. A decision support toolkit (DST) for improving the management and efficiency of COPD care is needed to respond to the needs of patients now and in the future. In collaboration with the COPD team of a hospital and community service in London, we conceptualised the pathway for COPD patients and developed a discrete event simulation model (DES) incorporating the dynamics of patient readmissions. A DES model or operational model at this scale has never been previously developed, despite many studies using other modelling and simulation techniques in COPD. Our model is the first of its kind to include COPD readmissions as well as assessing the quantifiable impact of re-designing COPD services. We demonstrate the impact of post-exacerbation pulmonary rehabilitation (PEPR) policy and observe that PEPR would be cost-effective with improvements in quality-adjusted life years (QALYs), reduction in emergency readmissions and occupied bed days. The DST improves the understanding of the impact of scenarios (activities, resources, financial implications etc.) for key decision makers and supports commissioners in implementing the interventions.",
keywords = "COPD, Patient flow modelling, decision support toolkit, discrete event simulation, readmission",
author = "Usame Yakutcan and Eren Demir and John Hurst and Paul Taylor",
note = "This is an Accepted Manuscript version of 'Usame Yakutcan, Eren Demir, John R. Hurst & Paul C. Taylor (2020) Patient pathway modelling using discrete event simulation to improve the management of COPD, Journal of the Operational Research Society, DOI: 10.1080/01605682.2020.1854626'. It is deposited under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.” Publisher Copyright: {\textcopyright} Operational Research Society 2020. ",
year = "2020",
month = dec,
day = "30",
doi = "10.1080/01605682.2020.1854626",
language = "English",
journal = "Journal of the Operational Research Society",
issn = "0160-5682",
publisher = "Palgrave Macmillan Ltd.",

}

RIS

TY - JOUR

T1 - Patient Pathway Modelling Using Discrete Event Simulation to Improve the Management of COPD

AU - Yakutcan, Usame

AU - Demir, Eren

AU - Hurst, John

AU - Taylor, Paul

N1 - This is an Accepted Manuscript version of 'Usame Yakutcan, Eren Demir, John R. Hurst & Paul C. Taylor (2020) Patient pathway modelling using discrete event simulation to improve the management of COPD, Journal of the Operational Research Society, DOI: 10.1080/01605682.2020.1854626'. It is deposited under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited.” Publisher Copyright: © Operational Research Society 2020.

PY - 2020/12/30

Y1 - 2020/12/30

N2 - The number of people affected by chronic obstructive pulmonary disease (COPD) is increasing and the hospital readmission rate is remarkably high. Therefore, healthcare professionals and managers have financial and workforce-related pressures. A decision support toolkit (DST) for improving the management and efficiency of COPD care is needed to respond to the needs of patients now and in the future. In collaboration with the COPD team of a hospital and community service in London, we conceptualised the pathway for COPD patients and developed a discrete event simulation model (DES) incorporating the dynamics of patient readmissions. A DES model or operational model at this scale has never been previously developed, despite many studies using other modelling and simulation techniques in COPD. Our model is the first of its kind to include COPD readmissions as well as assessing the quantifiable impact of re-designing COPD services. We demonstrate the impact of post-exacerbation pulmonary rehabilitation (PEPR) policy and observe that PEPR would be cost-effective with improvements in quality-adjusted life years (QALYs), reduction in emergency readmissions and occupied bed days. The DST improves the understanding of the impact of scenarios (activities, resources, financial implications etc.) for key decision makers and supports commissioners in implementing the interventions.

AB - The number of people affected by chronic obstructive pulmonary disease (COPD) is increasing and the hospital readmission rate is remarkably high. Therefore, healthcare professionals and managers have financial and workforce-related pressures. A decision support toolkit (DST) for improving the management and efficiency of COPD care is needed to respond to the needs of patients now and in the future. In collaboration with the COPD team of a hospital and community service in London, we conceptualised the pathway for COPD patients and developed a discrete event simulation model (DES) incorporating the dynamics of patient readmissions. A DES model or operational model at this scale has never been previously developed, despite many studies using other modelling and simulation techniques in COPD. Our model is the first of its kind to include COPD readmissions as well as assessing the quantifiable impact of re-designing COPD services. We demonstrate the impact of post-exacerbation pulmonary rehabilitation (PEPR) policy and observe that PEPR would be cost-effective with improvements in quality-adjusted life years (QALYs), reduction in emergency readmissions and occupied bed days. The DST improves the understanding of the impact of scenarios (activities, resources, financial implications etc.) for key decision makers and supports commissioners in implementing the interventions.

KW - COPD

KW - Patient flow modelling

KW - decision support toolkit

KW - discrete event simulation

KW - readmission

UR - http://www.scopus.com/inward/record.url?scp=85098652607&partnerID=8YFLogxK

U2 - 10.1080/01605682.2020.1854626

DO - 10.1080/01605682.2020.1854626

M3 - Article

JO - Journal of the Operational Research Society

JF - Journal of the Operational Research Society

SN - 0160-5682

ER -