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Keywords Health care, Simulation, Problem solving, Modeling
Abstract Discrete event simulation (DES) application is not as widely perceived as being useful for problem solving in the health-care arena as in other application areas. Suggests that this might be due to the way DES is applied in health-care modelling, as it follows a traditionally based-on-engineering approach. This may not be a problem in itself,' however, health-care systems are often complex in that they involve multiple decision-makers and thus understanding and communication between the various stakeholders are potentially problematic. Thinks that problem understanding and efficient communication tools largely contribute to the solution; consequently, proposes a modeling approach to enhance stakeholder understanding and communication. The approach is based on participation of stakeholders; it is also iterative rather than step-based, To demonstrate this approach, gives an example, aiming to show how this approach has been used successfully to facilitate the understanding process, concluding that involving stakeholders throughout not only helps them to understand their problem better, but also enables them to more fully appreciate the findings resulting from the model This approach thus serves usefully to enrich the communication between the stakeholders.
Introduction
The application of discrete event simulation (DES) modelling in the health-care sector is not as widely used when compared with other sectors such as military, manufacturing and logistics applications, despite the fact that simulation has been successfully applied in these other sectors for more than three decades (Sanchez et al., 2000; Jun et al., 1999). For simplicity from this point and throughout this paper the term simulation is used to denote DES to avoid confusion with other types of simulations. This paper discusses issues related to the application of simulation in health care and proposes a modelling approach that is suitable for this particular application area. The paper looks at the nature of health-care systems and discusses why a waterfall engineering-- based modelling technique may not be the most appropriate approach when tackling problems in health-care delivery or, indeed, in fastest-changing businesses, where problems are not well defined. Before discussing the relevant issues, the paper gives a brief introduction on the up-to-date uses of simulation in health care and provides an overview of the traditional approaches of modelling. A critique is given for these...