T. Bolt

Stakeholder engagement in health care simulation

The RIGHT project (Research Into Global Healthcare Tools, http://www.right.org.uk/) is a collaborative project involving five British universities, funded by the UKs Engineering and Physical Sciences Research Council. Phase 1 of the project is due to be completed in October 2009, and this paper describes one strand of the research, namely identifying some of the issues with involving stakeholders in simulation modeling in healthcare. Not the least of these is actually identifying who the stakeholders are! Other problems identified are equally tricky, as they involve deeply rooted cultural and behavioral attitudes as well as complex organizational relationships. One of the underlying aims of the next phase of RIGHT is to tackle these problems and to develop a methodology for more effective stakeholder engagement with simulation modeling.

Overcoming the barriers: a qualitative study of simulation adoption in the NHS

This paper addresses a key issue in the health OR literature, namely the apparent failure of OR modelling to become embedded and widely implemented within healthcare organisations. The research presented here is a case study to evaluate the adoption of one particular simulation modelling tool, Scenario Generator (S:G), which was developed by the SIMUL8 Corporation in a PPI partnership with the UKs National Health Service (NHS) Institute for Innovation and Improvement. The study involved semi-structured interviews with employees of 28 Primary Care Trusts who had all been engaged in some way with the initiative, with participants classified as ‘Not Started’, ‘Given Up’ and ‘Actively Using’. This paper presents a brief summary of barriers and facilitators to the successful use of the S:G software, but its main purpose is to focus more broadly on factors influencing the successful adoption of simulation tools in general within healthcare organisations. The insights gained in this study are relevant to improving the uptake of OR modelling in general within the NHS.

Network technologies and messaging for the community-based care of the elderly

This paper examines the use of communication networks and messaging in the community-based care of the elderly over the next decade. This is based on a review of political, economic and social institutional pressures as well as technological trends. These are drawn primarily from studies in the UK and Japan. In examining the support of community-based care of the elderly through network technologies, the two key applications identified are messaging for the coordination of care services and messaging for the transfer of remote monitoring data from sensor systems in the homecare environment. An assessment of the platforms expected to emerge to support these over the next decade is offered. We find the approach of messaging between separate localised systems sharing data through standardised XML schemas with common vocabularies, as proposed by the dominant international standardisation organisations, to be convincing.

Information quality in home care coordination services

With the increasing use of telecare, attention is being given to the information quality (IQ) issues related to the collection, storage and sharing of user data. This is particularly true for personal information and informal information flows between caregivers and care service providers. We examined data from interviews with developers and users during the pilot stage of a Web and mobile phone accessible database and software application to support carers by providing access to personal care records. The standard IQ dimensions reflect a view in which the supplier passes information to the user. This does not fully reflect the relationship and information flow in care record systems which hold and collect quite personal user data. The three additional IQ dimensions necessary are updateability, interoperability and portability — these form a new category, ‘Controllability IQ’.