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Mixing methodologies to enhance the implementation of healthcare operational research

Author

Listed:
  • R Sachdeva

    (Medical College of Wisconsin
    Children's Hospital and Health System, Children's Research Institute, Children's Hospital of Wisconsin, and National Outcomes Center)

  • T Williams

    (University of Southampton)

  • J Quigley

    (University of Strathclyde)

Abstract

Healthcare Operational Research (OR) has had limited success in achieving a sufficient level of stakeholder acceptance to lead to implementation of results. This research study is aimed at combining OR methodologies to achieve greater acceptance of results for organizational change. Patient flow delays in the Paediatric intensive care unit (PICU) at Children's Hospital of Wisconsin were identified using case studies. Patient flow was modelled using hard OR (simulation) using case study findings, with active stakeholder participation, and enhanced with outcomes research. Outcomes research allowed achieving greater clinical relevance of OR findings. Results from hard OR, particularly for politically sensitive issues, were persuasive but inadequate to result in change. Soft OR (cognitive mapping) was used to identify new issues and enhance results. Consequently, the planned PICU expansion was deferred, and resources focused on improving staffing strategies identified independently from both hard and soft OR. These findings suggest that: (1) Outcomes research can play a unique role to enhance results in healthcare OR. (2) After obtaining a holistic understanding of the system using hard and soft OR, stakeholders are willing to implement results from each independently, supporting the development of a common form of knowledge, which is consistent with Mixed-Mode Modelling. (3) Hard OR, enhanced with outcomes research, with active stakeholder participation, and combined with soft OR, results in greater acceptance and sustained organizational change.

Suggested Citation

  • 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.
    • Handle: RePEc:pal:jorsoc:v:58:y:2007:i:2:d:10.1057_palgrave.jors.2602293
    DOI: 10.1057/palgrave.jors.2602293
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    References listed on IDEAS

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    Cited by:

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    6. Kato, Hironori & Shiroyama, Hideaki & Nakagawa, Yoshinori, 2014. "Public policy structuring incorporating reciprocal expectation analysis," European Journal of Operational Research, Elsevier, vol. 233(1), pages 171-183.
    7. C Martin & M Metcalfe & H Harris, 2009. "Developing an implementation capacity: justifications from prior research," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 60(6), pages 859-868, June.
    8. 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.
    9. Ackermann, Fran, 2012. "Problem structuring methods ‘in the Dock’: Arguing the case for Soft OR," European Journal of Operational Research, Elsevier, vol. 219(3), pages 652-658.
    10. Thomas Rohleder & Peter Lewkonia & Diane Bischak & Paul Duffy & Rosa Hendijani, 2011. "Using simulation modeling to improve patient flow at an outpatient orthopedic clinic," Health Care Management Science, Springer, vol. 14(2), pages 135-145, June.

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