Evaluating the peri-operative process in a surgical setting through simulation modelling

The SIMCARE research program aims to develop methods to evaluate policy alternatives in the delivery of cardiac surgical care by using computer models to simulate the peri-operative process from initial referral to hospital discharge. The focus is on surgical coronary revascularization as the procedure is well-structured in terms of the activities involved and lends itself to study and improvement. This project aims to expand the SIMCARE model to increase understanding of the implications of changes in the organization of surgical services. Computer simulation is a method used by operations researchers to evaluate a system's performance; the SIMCARE project has been used to model patient flow through surgical care and to identify likely outcomes in policy initiatives in hospital settings. There is an increasing understanding that a multidisciplinary approach linking health services research, computer science and operations research is needed to evaluate and improve the delivery of surgical care through simulation modelling. This project will add to the SIMCARE model, which was designed to model a large hospital that provides cardiac surgical care to residents of British Columbia, by incorporating different service sizes and duties between surgeons as practised at the Halifax Infirmary, Queen Elizabeth II Health Sciences Centre in Halifax, Nova Scotia. This model will include various case-mixes and arrival rates of incoming patients. The proposed project will involve the planning, execution, analysis and interpretation of simulation experiments to facilitate research on how patient flow is effected through the peri-operative process with varied initial situations. This project has important implications for policy makers and will add an increased knowledge and understanding of cardiac surgical care processes in Canada. Knowledge gained from this project will be disseminated by preparing and submitting findings for publication in a peer-reviewed journal.