Developing a participative user tool to aid the conceptual development of simulation models in healthcare.

The NHS spending is expected to increase from 70 billion a year to more than 90 billion by 2007/8 but this may not be enough for the government to achieve the planned health care delivery targets because it faces new challenges such as the increasing demands of a population that is living longer. Patients will only benefit from this increase in spending if the health care delivery system is more efficient and effective. Discrete event simulation modelling has been touted as an ideal tool in assisting decision makers in bringing about efficiency in health care as it is able to model its inherent complexity and variability and as a result hundreds of simulation models have been built over the last 30 years but only a handful of these have reported implementation or have impacted on policy. Evidence suggests that one factor inhibiting implementation is the limited participation of health care decision makers and stakeholders in the model development. The most important part of model development is conceptual modelling because it is about deciding what and how to model. Currently there are no formal approaches to aid the development of conceptual models in health care. We propose to develop an approach stemming from the problem structuring field of Operational Research that will specifically aim to help health care administrators and clinicians take a more active part in the development of health care conceptual models. We also expect that a more active part will lead them to buy in to the process and findings and to support their implementation. Finally, we expect that this will enable both expert and novice modellers to build more relevant discrete event simulation models in health care by better communicating with stakeholders.