Hyperacute stroke care and NHS England's business plan

Abstract

Computer simulation, coupled with high quality data, can help in decision making

Systems modelling and simulation in health service design, delivery and decision making

“…Healthcare systems need to be highly responsive to acute stroke emergencies in order to minimise the substantial costs and consequences associated with stroke survival and rehabilitation 25. In recent years, systems modelling and simulation has been used to aid the design of responsive stroke care systems to meet the time sensitive requirements of treating ischaemic strokes with recombinant tissue plasminogen activator (rtPA) 25 26 27 28 29 30 31 32 33.…”

“…In recent years, systems modelling and simulation has been used to aid the design of responsive stroke care systems to meet the time sensitive requirements of treating ischaemic strokes with recombinant tissue plasminogen activator (rtPA) 25 26 27 28 29 30 31 32 33. There is growing evidence that this work leads to implementation changes and real system improvement 34.…”

Validation of a decision support model for investigation and improvement in stroke thrombolysis

“…"Save a minute -save a day" model is an example of a complex OR/MS model in stroke care systems domain. Various OR/MS models addressing a number of interventions in stroke care systems have been proposed by OR/MS researchers and practitioners ( Churilov & Donnan, 2012 ).These applications target, in particular, the areas of stroke care operations improvement ( Bayer, Petsoulas, Cox, Honeyman, & Barlow, 2010;Churilov et al, 2013;Cordeaux, Hughes, & Elder, 2011;Mar, Arrospide, & Comas, 2010;Pitt et al, 2012 ), economic analysis ( Bayer et al, 2010;Davidson, Husberg, Janzon, Oldgren, & Levin, 2013;Ghijben, Lancsar, & Zavarsek, 2014;Mar et al, 2010 ), public policy ( Bayer et al, 2010;Churilov et al, 2013;Davidson, et al, 2013;Ghijben et al, 2014;Monks, Pitt, Stein, & James, 2014;Yang, Chen, Chitkara, & Xu, 2014 ), and clinical decision making ( Ghijben et al, 2014;Mar et al, 2010;Monks et al, 2012;Pitt et al, 2012;Yang et al, 2014 ).…”

Simulation of stroke care systems

“…Indirect costs, from benefits payments and informal care represent £2.5b (Saka et al 2009). To reduce the substantial human and economic burdens of surviving stroke healthcare systems must be highly responsive to the emergency an acute stroke represents (Monks et al 2014) and also provide sufficient treatment capacity for lengthy rehabilitation. The good news is that there is growing evidence that simulation modeling, in particular discrete-event simulation (DES), can play an important role in understanding and designing improvements in acute stroke systems in order to reduce this disability burden (Bayer et al 2010;Churilov and Donnan 2012;Churilov et al 2013;Cordeaux et al 2011;Lahr et al 2013a, b;McClean et al 2011;Monks et al 2015;Monks et al 2012;Monks et al 2014;Pitt et al 2012).…”