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A case of an intervention in an outpatients department

Author

Listed:
  • B Lehaney

    (University of Luton)

  • S A Clarke

    (University of Luton)

  • R J Paul

    (Brunel University)

Abstract

This paper is an account of a case intervention, undertaken at a National Health Service hospital outpatients department. The intervention utilised a soft systems approach, to address gaps between the customers' and providers' expectations, and simulation was used within this framework. A procedure to reduce unexpected non–attendance of patients has been implemented. Patient bookings are now scheduled according to simple rules, with the result that in–clinic waiting times have been reduced. A model of the intervention process has been accepted by the key stakeholders as a sensible framework for continuing investigations. More widely, the participants increased their knowledge of their own systems. The results from the case suggest that the time spent following this approach may be worthwhile in some interventions, but there are concerns relating to the time needed, and the cost of such an approach. The paper provides a critique of the framework and the intervention, and concludes that this approach is probably viable in unpaid, collaborative, investigations where there is little or no cost. However, time and cost may prove prohibitive in the case of paid consultancy.

Suggested Citation

  • B Lehaney & S A Clarke & R J Paul, 1999. "A case of an intervention in an outpatients department," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 50(9), pages 877-891, September.
  • Handle: RePEc:pal:jorsoc:v:50:y:1999:i:9:d:10.1057_palgrave.jors.2600796
    DOI: 10.1057/palgrave.jors.2600796
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    Cited by:

    1. Bowers, John & Mould, Gillian, 2004. "Managing uncertainty in orthopaedic trauma theatres," European Journal of Operational Research, Elsevier, vol. 154(3), pages 599-608, May.
    2. Kemper, Benjamin & Klaassen, Chris A.J. & Mandjes, Michel, 2014. "Optimized appointment scheduling," European Journal of Operational Research, Elsevier, vol. 239(1), pages 243-255.
    3. Kim, Seung-Chul & Horowitz, Ira, 2002. "Scheduling hospital services: the efficacy of elective-surgery quotas," Omega, Elsevier, vol. 30(5), pages 335-346, October.
    4. Howick, Susan & Ackermann, Fran, 2011. "Mixing OR methods in practice: Past, present and future directions," European Journal of Operational Research, Elsevier, vol. 215(3), pages 503-511, December.
    5. S Howick & C Eden, 2011. "Supporting strategic conversations: the significance of a quantitative model building process," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 62(5), pages 868-878, May.
    6. J S Edwards & M J Hall & D Shaw, 2005. "Proposing a systems vision of knowledge management in emergency care," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 56(2), pages 180-192, February.
    7. R B van der Meer & L A Rymaszewski & H Findlay & J Curran, 2005. "Using OR to support the development of an integrated musculo-skeletal service," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 56(2), pages 162-172, February.
    8. Harper, Alison & Mustafee, Navonil & Yearworth, Mike, 2021. "Facets of trust in simulation studies," European Journal of Operational Research, Elsevier, vol. 289(1), pages 197-213.
    9. T Eldabi & R J Paul & T Young, 2007. "Simulation modelling in healthcare: reviewing legacies and investigating futures," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 58(2), pages 262-270, February.
    10. Guillaume Lamé & Oualid Jouini & Julie Stal-Le Cardinal, 2020. "Combining Soft Systems Methodology, Ethnographic Observation and Discrete-Event Simulation: A Case Study in Cancer Care," Post-Print hal-02095031, HAL.
    11. Robinson, Stewart & Worthington, Claire & Burgess, Nicola & Radnor, Zoe J., 2014. "Facilitated modelling with discrete-event simulation: Reality or myth?," European Journal of Operational Research, Elsevier, vol. 234(1), pages 231-240.
    12. B Lehaney & D Malindzak & Z Khan, 2008. "Simulation modelling for problem understanding: a case study in the East Slovakia Coal Industry," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 59(10), pages 1332-1339, October.
    13. Marie Matta & Sarah Patterson, 2007. "Evaluating multiple performance measures across several dimensions at a multi-facility outpatient center," Health Care Management Science, Springer, vol. 10(2), pages 173-194, June.
    14. Alireza Moumivand & Adel Azar & Abbas Toloie Eshlaghy, 2022. "Combined soft system methodology and agent‐based simulation for multi‐methodological modelling," Systems Research and Behavioral Science, Wiley Blackwell, vol. 39(2), pages 200-217, March.
    15. R Sachdeva & T Williams & J Quigley, 2007. "Mixing methodologies to enhance the implementation of healthcare operational research," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 58(2), pages 159-167, February.
    16. M den Hengst & G-J de Vreede & R Maghnouji, 2007. "Using soft OR principles for collaborative simulation: a case study in the Dutch airline industry," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 58(5), pages 669-682, May.
    17. Gogi, Anastasia & Tako, Antuela A. & Robinson, Stewart, 2016. "An experimental investigation into the role of simulation models in generating insights," European Journal of Operational Research, Elsevier, vol. 249(3), pages 931-944.
    18. Tako, Antuela A. & Kotiadis, Kathy, 2015. "PartiSim: A multi-methodology framework to support facilitated simulation modelling in healthcare," European Journal of Operational Research, Elsevier, vol. 244(2), pages 555-564.
    19. K Kotiadis & J Mingers, 2006. "Combining PSMs with hard OR methods: the philosophical and practical challenges," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 57(7), pages 856-867, July.

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