Clinical pathway simulation#

Clinical pathway simulation aims to mimic the passage of individual patients through a clinical pathway. Each patient may take a different route through the pathway, and may take different amounts of time in process steps, depending on the model logic and distributions of timings used.

Analysis of patient pathway data coupled with computer simulation has previously allowed investigation and improvement of thrombolysis use in individual hospitals - increasing both the number of patients treated and reducing door-to-needle times [1,2]. These models have usually focused solely on the speed of the acute stroke pathway from arrival at hospital to treatment with thrombolysis [1]. Interest in the use of simulation for improving the performance of the acute stroke pathway has reached an interest such that a common framework has been proposed [3].

  1. Monks T, Pitt M, Stein K, James M. Maximizing the population benefit from thrombolysis in acute ischemic stroke: A modeling study of in-hospital delays. Stroke. 2012;43(10):2706–11.

  2. Lahr M, van der Zee D-J, Luijckx G, Vroomen P, Buskens E. A simulation-based approach for improving utilization of thrombolysis in acute brain infarction. Med Care 2013;51(12):1101–5. Available from: http://mgetit.lib.umich.edu/sfx_locater?sid=EMBASE&issn=00257079&id=doi:10.1097/MLR.0b013e3182a3e505&atitle=A+simulation-based+approach+for+improving+utilization+of+thrombolysis+in+acute+brain+infarction&stitle=Med.+Care&title=Medica

  3. Monks T, van der Zee D-J, Lahr M, Allen M, Pearn K, James MA, et al. A framework to accelerate simulation studies of hyperacute stroke systems. Oper Res Heal Care. 2017;15:57–67. Available from: http://linkinghub.elsevier.com/retrieve/pii/S2211692317300127