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Combining Soft Systems Methodology, Ethnographic Observation and Discrete-Event Simulation: A Case Study in Cancer Care

Author

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  • Guillaume Lamé

    (CAM - University of Cambridge [UK], THIS.institute - THIS Institute (The Healthcare Improvement Studies Institute) - Department of Public Health and Primary Care, University of Cambridge - CAM - University of Cambridge [UK])

  • Oualid Jouini

    (LGI - Laboratoire Génie Industriel - EA 2606 - CentraleSupélec)

  • Julie Stal-Le Cardinal

    (LGI - Laboratoire Génie Industriel - EA 2606 - CentraleSupélec)

Abstract

We describe a project where Discrete-Event Simulation (DES) is combined with Soft Systems Methodology (SSM) and ethnographic observation to support the improvement of patient flows in an outpatient chemotherapy unit and a chemotherapy preparation pharmacy unit. The project combines three interesting characteristics. First, we rely on ethnographic observation to explore the problem situation and frame the problem, a technique rarely reported in operational research (OR). Second, this leads us to define several root definitions, an aspect that remains overlooked in studies combining SSM and DES. Finally, the project stands at the interface between two departments (outpatient oncology unit and chemotherapy preparation pharmacy unit), a situation seldom explored in healthcare OR but where SSM has arguably a lot to offer to help identify and accommodate diverging objectives. We framed the problem, developed a simulation model, explored scenarios and refined a preferred one into a new business process. However, the proposed changes were not implemented. We analyse the outcomes of the project, the contribution of each method and their integration into an intervention. The paper provides insights on how SSM and DES can be combined in practice, and how the potential of ethnographic observation can be leveraged in this context.

Suggested Citation

  • 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.
    • Handle: RePEc:hal:journl:hal-02095031
    DOI: 10.1080/01605682.2019.1610339
    Note: View the original document on HAL open archive server: https://hal.science/hal-02095031
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    References listed on IDEAS

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    1. Hadid, Majed & Elomri, Adel & Mekkawy, Tarek El & Jouini, Oualid & Kerbache, Laoucine & Hamad, Anas, 2022. "Operations management of outpatient chemotherapy process: An optimization-oriented comprehensive review," Operations Research Perspectives, Elsevier, vol. 9(C).
    2. Majed Hadid & Adel Elomri & Regina Padmanabhan & Laoucine Kerbache & Oualid Jouini & Abdelfatteh El Omri & Amir Nounou & Anas Hamad, 2022. "Clustering and Stochastic Simulation Optimization for Outpatient Chemotherapy Appointment Planning and Scheduling," IJERPH, MDPI, vol. 19(23), pages 1-34, November.
    3. Denicolai, Stefano & Previtali, Pietro, 2020. "Precision Medicine: Implications for value chains and business models in life sciences," Technological Forecasting and Social Change, Elsevier, vol. 151(C).
    4. Ricardi S. Adnan & Sonny Harry B. Harmadi & Sudarsono Hardjosoekarto & Nur Muhammaditya, 2023. "Institutional Reconstruction of Promoting and Maintaining the Level of Compliance with Health Protocols in Indonesia during the Pandemic," Systemic Practice and Action Research, Springer, vol. 36(3), pages 377-406, June.

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    Keywords

    Soft OR; Problem Structuring Methods; Healthcare OR; Soft Systems Methodology; Ethnographic observation; Simulation;
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