DGHPSim: District General Hospital Performance Simulation

Supporting smart thinking to reduce waiting times

DGHPSim is a suite of models that simulate individual patients as they enter and move through a hospital. It covers outpatients, inpatients and patients needing emergency care. DGHPSim models support smart thinking about reducing waiting times whilst avoiding side effects.

By the end of 2008 NHS Trusts must ensure that patients wait no longer than 18 weeks from GP referral to treatment (the 18-week RTT target). DGHPSIm models can be used to select policies to meet this target.

The models can be used to estimate waiting times at the stages through which patients pass as they experience hospital care. Using them, policy makers, managers and clinicians can see where bottlenecks exist and cause unnecessary waiting. Instead of experimenting with new service configurations in the hospital to find ways to remove these problems, the experiments can be simulated in DGHPSim.

For example:

• What would be the effect of increasing the proportion of elective surgery completed as day-cases?
• What if we devote more beds to elective rather emergency care?
• What would happen to waiting times if GP referrals increase?

A DGHPSim experiment shows the effect on waiting times of such changes but also shows side effects. For example, if we increase the proportion of beds used for elective care, are we at risk of not meeting emergency demand?

Answering such questions without smart, systems thinking is all but impossible. Modern hospitals are complex organisations in which resources are shared and, without decision support tools, it is almost impossible to see what will happen if we make such changes.

A busy hospital is rather like a balloon. Squeeze in one place and the balloon changes shape - sometimes in ways we expect. Squeeze too hard and the balloon bursts!

DGHPSim is funded by the Engineering and Physical Sciences Research Council (Grant ref: EP/C010752/1)