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The Application of Operations Research Methodologies to the Delivery of Care Model for Traumatic Spinal Cord Injury: The Access to Care and Timing Project

JOURNAL OF NEUROTRAUMA, 2012 · DOI: 10.1089/neu.2012.2317 · Published: September 1, 2012

Spinal Cord InjuryHealthcare

Simple Explanation

The Access to Care and Timing (ACT) project was developed to model the health care delivery system in Canada for patients with traumatic SCI. Techniques from Operations Research, such as simulation modeling, were used to predict the impact of best practices and policy initiatives on outcomes related to both the system and patients. The project aims to create knowledge tailored to SCI care and develop tools to assist policymakers and stakeholders in making informed decisions. By modeling all phases of SCI health care delivery (pre-hospital, acute care, and rehabilitation) as one comprehensive and integrated system, the effects of implementing a change in policy or practice at one end of the continuum can be quantitatively estimated for all the facilities that comprise that system.

Study Duration
Long-term project divided into three phases
Participants
35 participants including clinicians, researchers, administrators, policy decision makers, and persons with SCI
Evidence Level
Not specified

Key Findings

  • 1
    There was wide diversity in how care is provided among the SCI centers.
  • 2
    Detailed process mapping allowed subject matter experts to view their contribution to SCI health care delivery as part of an integrated system, promoting discussion about barriers to patient flow.
  • 3
    The ACT model, comprising the DES and the HPM, has been developed and can now be used in future phases of the ACT project (ACT/II and ACT/III) to identify the attributes of an SCI Program of Excellence.

Research Summary

The Access to Care and Timing (ACT) project uses Operations Research techniques to model and optimize the health care delivery system for traumatic spinal cord injury (SCI) in Canada. Process mapping was crucial for documenting patient flow and resources, forming the basis for computer simulations that predict the impact of policies and best practices. The ACT model, including Discrete Event Simulation (DES) and a Health Progression Model (HPM), aims to identify attributes of an SCI Program of Excellence and inform evidence-based decision-making for improved patient outcomes and system efficiency.

Practical Implications

Informed Decision Making

The ACT model provides evidence to support clinical decision making, inform standards of care, and engage policymakers.

Improved Patient Flow

Identifying and addressing barriers to patient flow can lead to more efficient and effective health care delivery.

Optimized Resource Allocation

The model can help predict the impact of innovations and interventions before they are implemented, ensuring resources are used effectively.

Study Limitations

  • 1
    Model accuracy is dependent on the availability and quality of input data.
  • 2
    Generalised data may reduce the relevance and specificity of model predictions.
  • 3
    The development and validation of the simulation model was only possible due to the availability of input data to populate the model, and the results can only be as accurate as the data.

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