Korina Katsaliaki

Applications of Simulation within the Healthcare Context

A large number of studies have applied simulation to a multitude of issues relating to healthcare. These studies have been published in a number of unrelated publishing outlets, which may hamper the widespread reference and use of such resources. In this paper, we analyse existing research in healthcare simulation in order to categorise and synthesise it in a meaningful manner. Hence, the aim of this paper is to conduct a review of the literature pertaining to simulation research within healthcare in order to ascertain its current development. A review of approximately 250 high-quality journal papers published between 1970 and 2007 on healthcare-related simulation research was conducted. The results present a classification of the healthcare publications according to the simulation techniques they employ; the impact of published literature in healthcare simulation; a report on demonstration and implementation of the studies’ results; the sources of funding; and the software used. Healthcare planners and researchers will benefit from this study by having ready access to an indicative article collection of simulation techniques applied to healthcare problems that are clustered under meaningful headings. This study facilitates the understanding of the potential of different simulation techniques in solving diverse healthcare problems.

Using Simulation to Improve the Blood Supply Chain

This case study is concerned with analysing policies for managing the blood inventory system in a typical UK hospital supplied by a regional blood centre. The objective of the project is to improve procedures and outcomes by modelling the entire supply chain for that hospital, from donor to recipient. The supply chain of blood products is broken down into material flows and information flows. Discrete-event simulation is used to determine ordering policies leading to reductions in shortages and wastage, increased service levels, improved safety procedures and reduced costs, by employing better system coordination. In this paper we describe the model and present results for a representative medium-sized hospital. The model can be used by both the National Blood Service and by hospital managers as a decision support tool to investigate different procedures and policies.

Profiling Literature in Healthcare Simulation

The publications that relate to the application of simulation to healthcare have steadily increased over the years. These publications are scattered amongst various journals that belong to several subject categories, including operational research, health economics and pharmacokinetics. The simulation techniques that are applied to the study of healthcare problems are also various. The aim of this study, therefore, is to review healthcare simulation literature that have been published between 1970 and 2007 in high-quality journals belonging to various subject categories and that report on the application of four simulation techniques, namely, Monte Carlo simulation, discrete-event simulation, system dynamics and agent-based simulation. Arguably, journal impact factor is fundamental in assessing the quality of publications. Thus, the 201 publications selected for review have been queried from the ISI Web of Science® bibliographic database of high-impact research journals. Through a review of healthcare simulation literature the following three objectives have been realized: (a) papers have been categorized under the different simulation techniques, and the healthcare problems that each technique is employed to investigate are identified; (b) variables such as authors, article citations, etc., within our dataset of healthcare papers have been profiled; (c) turning point (strategically important) papers and authors have been identified through co-citation analysis of references cited by the papers in our dataset. The above objectives have been realized by devising and then employing a methodology for profiling literature. It is expected that this review paper will help the readers gain a broader understanding of research in healthcare simulation.

Facilitating the Analysis of a UK National Blood Service Supply Chain Using Distributed Simulation

In an attempt to investigate blood unit ordering policies, researchers have created a discrete-event model of the UK National Blood Service (NBS) supply chain in the Southampton area of the UK. The model has been created using Simul8, a commercial off-the-shelf (COTS) discrete-event simulation package (CSP). However, as more hospitals were added to the model, it was discovered that the length of time needed to perform a single simulation severely increased. It has been claimed that distributed simulation, a technique that uses the resources of many computers to execute a simulation model, can reduce simulation runtime. Further, an emerging standardized approach exists that supports distributed simulation with CSPs. These CSP Interoperability (CSPI) standards are compatible with the IEEE 1516 standard, the High Level Architecture (HLA), the de facto interoperability standard for distributed simulation. To investigate if distributed simulation can reduce the execution time of NBS supply chain simulation, this paper presents experiences of creating a distributed version of the CSP Simul8 according to the CSPI/HLA standards. It shows that the distributed version of the simulation does indeed run faster when the model reaches a certain size. Further, we argue that understanding the relationship of model features is key to performance. This is illustrated by experimentation with two different protocols implementations (using Time Advance Request (TAR) and Next Event Request (NER)). Our contribution is therefore the demonstration that distributed simulation is a useful technique in the timely execution of supply chains of this type and that careful analysis of model features can further increase performance.

Edutainment for Sustainable Development

Background. The ever-increasing demand for natural resources has led to the continuing depletion of resources. Reversing this trend will require knowledge of effective environmental management strategies and adoption of sustainable development practices by society at large. Thus, it is critical that citizens increase their awareness of sustainability and acquire managerial skills required to effect change. Use of decision games for teaching sustainable development is a step in this direction. Games present great opportunities as tools of edutainment (educational entertainment) for teaching and training, with positive effects on learning outcomes. Aim and Method. In this article, we undertake a methodological review of games on sustainable development, analyzing their underlying characteristics, including the stated focus of the games, game availability, number of players and their roles, their target age, game validation and evaluation, stakeholder involvement in game development, learning outcomes, and so on. A total of 49 games are included in this survey. Conclusion. Our findings suggest that the games used for teaching sustainable development have generally increased players’ understanding of issues around sustainability and have enhanced their knowledge of sustainable development strategies. Our classification of the games’ characteristics assists educational instructors and potential learners in identifying games that are best suited for their teaching and learning needs.

Comparing conventional and distributed approaches to simulation in a complex supply-chain health system

Decision making in modern supply chains can be extremely daunting due to their complex nature. Discrete-event simulation is a technique that can support decision making by providing what-if analysis and evaluation of quantitative data. However, modelling supply chain systems can result in massively large and complicated models that can take a very long time to run even with todays powerful desktop computers. Distributed simulation has been suggested as a possible solution to this problem, by enabling the use of multiple computers to run models. To investigate this claim, this paper presents experiences in implementing a simulation model with a ‘conventional’ approach and with a distributed approach. This study takes place in a healthcare setting, the supply chain of blood from donor to recipient. The study compares conventional and distributed model execution times of a supply chain model simulated in the simulation package Simul8. The results show that the execution time of the conventional approach increases almost linearly with the size of the system and also the simulation run period. However, the distributed approach to this problem follows a more linear distribution of the execution time in terms of system size and run time and appears to offer a practical alternative. On the basis of this, the paper concludes that distributed simulation can be successfully applied in certain situations.

Distributed simulation with COTS simulation packages: a case study in health care supply chain simulation

The UK National Blood Service (NBS) is a public funded body that is responsible for distributing blood and associated products. A discrete-event simulation of the NBS supply chain in the Southampton area has been built using the commercial off-the-shelf simulation package (CSP) Simul8. This models the relationship in the health care supply chain between the NBS processing, testing and issuing (PTI) facility and its associated hospitals. However, as the number of hospitals increase simulation run time becomes inconveniently large. Using distributed simulation to try to solve this problem, researchers have used techniques informed by SISOs CSPI PDG to create a version of Simul8 compatible with the high level architecture (HLA). The NBS supply chain model was subsequently divided into several sub-models, each running in its own copy of SimulS. Experimentation shows that this distributed version performs better than its standalone, conventional counterpart as the number of hospitals increases

Exploring the modelling and simulation knowledge base through journal co-citation analysis

Co-citation analysis is a form of content analysis that can be applied in the context of scholarly publications with the purpose of identifying prominent articles, authors and journals being referenced to by the citing authors. It identifies co-cited references that occur in the reference list of two or more citing articles, with the resultant co-citation network providing insights into the constituents of a knowledge domain (e.g., significant authors and papers). The contribution of the paper is twofold; (a) the demonstration of the added value of using co-citation analysis, and for this purpose the underlying dataset that is chosen is the peer-reviewed publication of the Society for Modeling and Simulation International (SCS)—SIMULATION; (b) the year 2012 being the 60th anniversary of the SCS, the authors hope that this paper will lead to further acknowledgement and appreciation of the Society in charting the growth of Modeling and Simulation (M&S) as a discipline.

A survey of serious games on sustainable development

The continuing depletion of natural resources has become a major focus for the society at large. There is an increasing recognition of the need to sustain an ecologically-balanced environment, while, at the same time, exploring and exploiting the natural resources to satisfy the ever-increasing demands of the human race. A profound solution to this is the adoption of sustainable development practices. Increasing the awareness towards a more sustainable future is thus critical, and one way to achieve this is through the use of decision games called “serious games”. Serious games are gaining in popularity as tools that add entertainment to teaching and training. In this paper we undertake a review of serious games on sustainable development with a view to facilitate the understanding of the issues around sustainability, to identify opportunities towards improving the feature-set of these games, and for enhancing knowledge around sustainable development strategies.

SCS: 60 years and counting! A time to reflect on the Society's scholarly contribution to M&S from the turn of the millennium

The Society for Modeling and Simulation International (SCS) is celebrating its 60th anniversary this year. Since its inception, the Society has widely disseminated the advancements in the field of modeling and simulation (M&S) through its peer-reviewed journals. In this paper we profile research that has been published in the journal SIMULATION: Transactions of the Society for Modeling and Simulation International from the turn of the millennium to 2010; the objective is to acknowledge the contribution of the authors and their seminal research papers, their respective universities/departments and the geographical diversity of the authors’ affiliations. Yet another objective is to contribute towards the understanding of the overall evolution of the discipline of M&S; this is achieved through the classification of M&S techniques and its frequency of use, analysis of the sectors that have seen the predomination application of M&S and the context of its application. It is expected that this paper will lead to further appreciation of the contribution of the Society in influencing the growth of M&S as a discipline and, indeed, in steering its future direction.