Optimising patient flow dynamics at a south African public hospital with resource constraints

Abstract

In this paper, an application of a System Dynamics (SD) model is presented, which explores the stages of patient flow processes. The model presented represents a participatory methodological framework for healthcare simulation studies, capable of tackling design challenges that emerge at various stages of the modelling and simulation process, ultimately leading to enhanced context-specific solutions. It is hoped this was achieved by highlighting the potential utilisation of SD simulation to generate a patient flow perspective of healthcare and developing dialogue, which enhanced the division of resource allocation surrounding the various stages of the patient flow processes. Challenges were analysed using SD archetypes and leverage points for intervention facilitated by PAR (Participatory Action Research) Reflection Points. Using SD archetypes can potentially aid hospital managers in recognising existing patterns of behaviour within the organisation. These archetypes provided valuable insights into the underlying system structures that produce such behavioural patterns. Through the application of system archetypes in the critical analysis of healthcare challenges, loopholes in management's strategic planning processes were identified. Furthermore, the study demonstrated the potential to challenge and overcome shortcomings in the hospital system by adapting future policy implementation, as evidenced by results from the modelling outcomes. Managerial structures may consider modifying policies to avoid potential pitfalls and prevent costly learning experiences by utilising data generated from the ‘what-if-scenario’ generated by the SD model.