Abstract
Stroke care has been identified as an area where operations research has great potential. In recent years there has been a small but sustained stream of discrete-event simulation case studies in modelling hyperacute stroke systems. The nature of such case studies has led to a fragmented knowledge base and high entry cost to stroke modelling research. Two common issues have faced researchers in stroke care: understanding the logistics and clinical aspects of stroke care and moving from these findings to an appropriately detailed model. We aim to accelerate studies in this area by introducing a conceptual modelling framework that is domain specific for stroke. A domain specific framework trades-off the wide applicability of a general framework against increased efficiency and reuse to support modelling in the problem domain. This compromise is appropriate when the problem domain is complex, of high value to society, and where the saving in future modelling effort is likely to be greater than the effort to create the framework. We detail the requirements of a domain specific conceptual model and then provide domain specific knowledge to support modellers in gaining an understanding of the problem situation, translating this knowledge into selected model outputs, inputs and content in the case of hyperacute stroke. We illustrate the use of the framework with an example based at a large hospital in the United Kingdom.
Highlights
The inaugural issue of Operations Research for Healthcare identified stroke care as an area where operations research had the opportunity to do much better [1]
In the years following this call to action, there have been a small number of discrete-event simulation (DES) studies focused on the logistics of hyperacute stroke care (e.g., [2,3,4])
Second we provide modellers of hyperacute stroke pathways (HASPs) with a common knowledge to efficiently develop their simulation models, thereby seeking to exploit similarities observed in stroke system set-up and the choice of simulation model components
Summary
The inaugural issue of Operations Research for Healthcare identified stroke care as an area where operations research had the opportunity to do much better [1]. In the years following this call to action, there have been a small number of discrete-event simulation (DES) studies focused on the logistics of hyperacute stroke care (e.g., [2,3,4]). Researchers have no structured advice to assist in the diagnosis of logistical issues facing stroke services or how to move beyond these findings and conceptualise an appropriately detailed model As such the researcher entry cost to this complex domain of health has remained high. Generic frameworks lack domain specific knowledge on system characteristics to improve both the quality and efficiency of model building As such they do little to lower the entry cost of researchers into a new complex domain such as stroke. The final section discusses the implications of the framework and future work
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