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Should doctors use their judgment? How a System Dynamics model elicited knowledge in neonatal care services. / Lebcir, Mohamed; Atun, Rifat A.

In: Journal of the Operational Research Society, Vol. 71, No. 7, 25.04.2020, p. 1113-1123.

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@article{fd58ea7f385b4aa39df0a08fd17e2fea,
title = "Should doctors use their judgment? How a System Dynamics model elicited knowledge in neonatal care services",
abstract = "Neonatal services, which provide care to babies born with medical complications, are under financial pressures in the United Kingdom (UK). The services are heavily regulated affecting efficiency. One possible solution is to reduce the length of stay (LoS) of babies and allow a degree of doctors{\textquoteright} clinical judgment to make decisions. The aim of this paper is to determine the impact of using clinical judgment on neonatal services performance. To achieve this aim, an system dynamics (SD) model was built and validated in a UK neonatal unit. The model was used initially to evaluate the impact of LoS reduction on performance as clinical judgment policies were rejected by participants. The counterintuitive results led to a behavioural change and participants accepted clinical judgment policies which the results indicated should lead to considerable performance improvement. Results{\textquoteright} implications and SD{\textquoteright}s modelling ability to foster learning and alter participants{\textquoteright} perceptions and behaviour are discussed.",
keywords = "OR in health, behavioural OR, neonatal services, simulation, system dynamics",
author = "Mohamed Lebcir and Atun, {Rifat A.}",
note = "{\textcopyright} 2020 Taylor & Francis. This is an Accepted Manuscript of an article published by Taylor & Francis in Journal of the Operational Research Society on 25 Apr 2020, available online: https://doi.org/10.1080/01605682.2020.1730252.",
year = "2020",
month = apr,
day = "25",
doi = "10.1080/01605682.2020.1730252",
language = "English",
volume = "71",
pages = "1113--1123",
journal = "Journal of the Operational Research Society",
issn = "0160-5682",
publisher = "Palgrave Macmillan Ltd.",
number = "7",

}

RIS

TY - JOUR

T1 - Should doctors use their judgment? How a System Dynamics model elicited knowledge in neonatal care services

AU - Lebcir, Mohamed

AU - Atun, Rifat A.

N1 - © 2020 Taylor & Francis. This is an Accepted Manuscript of an article published by Taylor & Francis in Journal of the Operational Research Society on 25 Apr 2020, available online: https://doi.org/10.1080/01605682.2020.1730252.

PY - 2020/4/25

Y1 - 2020/4/25

N2 - Neonatal services, which provide care to babies born with medical complications, are under financial pressures in the United Kingdom (UK). The services are heavily regulated affecting efficiency. One possible solution is to reduce the length of stay (LoS) of babies and allow a degree of doctors’ clinical judgment to make decisions. The aim of this paper is to determine the impact of using clinical judgment on neonatal services performance. To achieve this aim, an system dynamics (SD) model was built and validated in a UK neonatal unit. The model was used initially to evaluate the impact of LoS reduction on performance as clinical judgment policies were rejected by participants. The counterintuitive results led to a behavioural change and participants accepted clinical judgment policies which the results indicated should lead to considerable performance improvement. Results’ implications and SD’s modelling ability to foster learning and alter participants’ perceptions and behaviour are discussed.

AB - Neonatal services, which provide care to babies born with medical complications, are under financial pressures in the United Kingdom (UK). The services are heavily regulated affecting efficiency. One possible solution is to reduce the length of stay (LoS) of babies and allow a degree of doctors’ clinical judgment to make decisions. The aim of this paper is to determine the impact of using clinical judgment on neonatal services performance. To achieve this aim, an system dynamics (SD) model was built and validated in a UK neonatal unit. The model was used initially to evaluate the impact of LoS reduction on performance as clinical judgment policies were rejected by participants. The counterintuitive results led to a behavioural change and participants accepted clinical judgment policies which the results indicated should lead to considerable performance improvement. Results’ implications and SD’s modelling ability to foster learning and alter participants’ perceptions and behaviour are discussed.

KW - OR in health

KW - behavioural OR

KW - neonatal services

KW - simulation

KW - system dynamics

UR - http://www.scopus.com/inward/record.url?scp=85084358335&partnerID=8YFLogxK

U2 - 10.1080/01605682.2020.1730252

DO - 10.1080/01605682.2020.1730252

M3 - Article

VL - 71

SP - 1113

EP - 1123

JO - Journal of the Operational Research Society

JF - Journal of the Operational Research Society

SN - 0160-5682

IS - 7

ER -