Jafri Zulkepli

Hybrid simulation for modelling large systems: an example of integrated care model

Developing models for large systems is not a trivial task. Using only Discrete Event Simulation (DES) as a modelling technique may mean that the complexity of the underlying model will increase exponentially with the size of the model. An alternative to this is the use of System Dynamics (SD) for modeling large systems using the positive and negative feedback loops. However, for modelling a human-centric system like healthcare, DES is important as it provides individuality analysis; similarly, SD is important as it facilitates the whole systems approach. The combined application of OR/Simulation methods enable the symbiotic realization of the strengths of individual techniques, while reducing their limitations; in this paper it is suggested that a combined SD-DES approach (also referred to as hybrid technique) can be effectively used for modelling large systems. The example being used in this context is the modelling of an Integrated Care (IC) system in healthcare.

Towards a framework for conceptual model hybridization in healthcare

It is well documented that modeling large complex healthcare systems cannot be achieved using the traditional single-technique approach. Developing large healthcare models requires more than one way of thinking about it, as healthcare systems consist of multiple stakeholders, policies, types of patients and many more complex subsidiaries. Whilst the literature is abound with hybrid models and attempts to theorize multi-method approaches, there is limited guidance of how to go about building a hybrid model and when. In this paper we attempt to develop a guiding framework focusing identifying what issues to consider when building a hybrid model. This 3-phased framework is based on model decomposition into modules, assigning methods to these modules, and identification of communication strategies between them. We start our endeavor by focusing on two types of popular techniques, namely system dynamics and discrete event simulation.

Obesity prevention: Comparison of techniques and potential solution

Over the years, obesity prevention has been a broadly studied subject by both academicians and practitioners. It is one of the most serious public health issue as it can cause numerous chronic health and psychosocial problems. Research is needed to suggest a population-based strategy for obesity prevention. In the academic environment, the importance of obesity prevention has triggered various problem solving approaches. A good obesity prevention model, should comprehend and cater all complex and dynamics issues. Hence, the main purpose of this paper is to discuss the qualitative and quantitative approaches on obesity prevention study and to provide an extensive literature review on various recent modelling techniques for obesity prevention. Based on these literatures, the comparison of both quantitative and qualitative approahes are highlighted and the justification on the used of system dynamics technique to solve the population of obesity is discussed. Lastly, a potential framework solution based on sy...

Understanding the dynamic effects of returning patients toward emergency department density

This paper presents the development of a dynamic hypothesis for the effect of returning patients to the emergency department (ED). A logical tree from the Theory of Constraint known as Current Reality Tree was used to identify the key variables. Then, a hypothetical framework portraying the interrelated variables and its influencing relationships was developed using causal loop diagrams (CLD). The conceptual framework was designed as the basis for the development of a system dynamics model.This paper presents the development of a dynamic hypothesis for the effect of returning patients to the emergency department (ED). A logical tree from the Theory of Constraint known as Current Reality Tree was used to identify the key variables. Then, a hypothetical framework portraying the interrelated variables and its influencing relationships was developed using causal loop diagrams (CLD). The conceptual framework was designed as the basis for the development of a system dynamics model.

Developing a discrete event simulation model for university student shuttle buses

Providing shuttle buses for university students to attend their classes is crucial, especially when their number is large and the distances between their classes and residential halls are far. These factors, in addition to the non-optimal current bus services, typically require the students to wait longer which eventually opens a space for them to complain. To considerably reduce the waiting time, providing the optimal number of buses to transport them from location to location and the effective route schedules to fulfil the students’ demand at relevant time ranges are thus important. The optimal bus number and schedules are to be determined and tested using a flexible decision platform. This paper thus models the current services of student shuttle buses in a university using a Discrete Event Simulation approach. The model can flexibly simulate whatever changes configured to the current system and report its effects to the performance measures. How the model was conceptualized and formulated for future s...

Root causes occurrence of low BIM adoption in Malaysia: System dynamics modelling approach

The global implementation of BIM in the construction field is increasing worldwide. Due to the advantages offered by BIM, its implementation is considered important in the construction projects. Nevertheless, the Construction Industry Transformation Plan has reported that the adoption of Building Information Modelling (BIM) in Malaysia is still low and it is estimated at only 10 percent adoption amongst construction stake players. The barriers influencing the occurrence of low adoption BIM in Malaysia have been studied by some researchers. However, these researchers did not investigate the root causes which might lead to the recurring of the barriers to BIM adoption. Root causes that immediately occurrence of barriers, also known as precipitants or trigger causes. This conceptual paper developed the causal loop diagram (CLD) which presents the relationship between the perceived variables using system dynamic modelling approach. The findings revealed a novelty validated diagrams that design the holistic dynamic relationship on the root causes occurrence of low BIM adoption. Nonetheless, the diagram subject to more empirical testing for its practicability and further refinement upon more results expected to emerge as the research progresses.The global implementation of BIM in the construction field is increasing worldwide. Due to the advantages offered by BIM, its implementation is considered important in the construction projects. Nevertheless, the Construction Industry Transformation Plan has reported that the adoption of Building Information Modelling (BIM) in Malaysia is still low and it is estimated at only 10 percent adoption amongst construction stake players. The barriers influencing the occurrence of low adoption BIM in Malaysia have been studied by some researchers. However, these researchers did not investigate the root causes which might lead to the recurring of the barriers to BIM adoption. Root causes that immediately occurrence of barriers, also known as precipitants or trigger causes. This conceptual paper developed the causal loop diagram (CLD) which presents the relationship between the perceived variables using system dynamic modelling approach. The findings revealed a novelty validated diagrams that design the holistic dy...

Developing integrated patient pathways using hybrid simulation

Integrated patient pathways includes several departments, i.e. healthcare which includes emergency care and inpatient ward; intermediate care which patient(s) will stay for a maximum of two weeks and at the same time be assessed by assessment team to find the most suitable care; and social care. The reason behind introducing the intermediate care in western countries was to reduce the rate of patients that stays in the hospital especially for elderly patients. This type of care setting has been considered to be set up in some other countries including Malaysia. Therefore, to assess the advantages of introducing this type of integrated healthcare setting, we suggest develop the model using simulation technique. We argue that single simulation technique is not viable enough to represent this type of patient pathways. Therefore, we suggest develop this model using hybrid techniques, i.e. System Dynamics (SD) and Discrete Event Simulation (DES). Based on hybrid model result, we argued that the result is viabl...

Modeling the effect of sedentary behaviour on the prevention of population obesity using the system dynamics approach

Obesity is a medical condition where an individual has an excessive amount of body fat. There are many factors contributing to obesity and one of them is the sedentary behaviour. Rapid development in industrialization and urbanization has brought changes to Malaysia’s socioeconomic, especially the lifestyles of Malaysians. With this lifestyle transition, one of the impact is on weight and obesity. How does sedentary behaviour have an impact on the growth of Malaysian population’s weight and obesity? What is the most effective sedentary behaviour preventing strategy to obesity? Is it through reduction in duration or frequency of sedentary behaviour? Thus, the aim of this paper is to design an intervention to analyse the effect of decreasing duration and frequency of sedentary behaviour on the population reversion trends of average weight (AW), average body mass index (ABMI), and prevalence of overweight and obesity (POVB). This study combines the different strands of sub-models comprised of nutrition, phys...

Demand forecasting for automotive sector in Malaysia by system dynamics approach

In general, Proton as an automotive company needs to forecast future demand of the car to assist in decision making related to capacity expansion planning. One of the forecasting approaches that based on judgemental or subjective factors is normally used to forecast the demand. As a result, demand could be overstock that eventually will increase the operation cost; or the company will face understock, which resulted losing their customers. Due to automotive industry is very challenging process because of high level of complexity and uncertainty involved in the system, an accurate tool to forecast the future of automotive demand from the modelling perspective is required. Hence, the main objective of this paper is to forecast the demand of automotive Proton car industry in Malaysia using system dynamics approach. Two types of intervention namely optimistic and pessimistic experiments scenarios have been tested to determine the capacity expansion that can prevent the company from overstocking. Finding from ...

The effect of food portion sizes on the obesity prevention using system dynamics modelling

The rise in income and population growth have increased the demand for food and induced changes in food habits, food purchasing and consumption patterns in Malaysia. With this transition, one of the plausible causes of weight gain and obesity is the frequent consumption of outside food which is synonymous with bigger portion size. Therefore, the aim of this paper is to develop a system dynamics model to analyse the effect of reducing food portion size on weight and obesity prevention. This study combines the different strands of knowledge comprise of nutrition, physical activity and body metabolism. These elements are synthesized into a system dynamics model called SIMULObese. Findings from this study suggested that changes in eating behavior should not emphasize only on limiting the food portion size consumption. The efforts should also consider other eating events such as controlling the meal frequency and limiting intake of high-calorie food in developing guidelines to prevent obesity.