PURPOSE: Aims to describe a project carried out within Hampshire Social Services investigating potential care pathways for older people after discharge from hospital and to show the potential of the simulation methodology in such situations. DESIGN/METHODOLOGY/APPROACH: A discrete-event simulation was used to determine the system capacities and to estimate the likely associated reimbursement costs. FINDINGS: A prototype simulation model was developed showing the potential value of this approach. RESEARCH LIMITATIONS/IMPLICATIONS: Restrictions in data access shifted the focus from quantitative service mapping to a more descriptive approach. PRACTICAL IMPLICATIONS: Currently, many older patients experience delayed discharge from acute beds because of capacity limitations in Social Services' traditional post-acute care services. At the same time, new regulations require Local Authorities to reimburse NHS Acute Trusts if hospital discharge is delayed solely due to inadequate provision of social care assessments and services. In order to overcome the so-called "bed-blocking" problem, a new range of services termed "Intermediate Care" has been introduced to offer alternative options for older patients. These services are examined in terms of capacity and appropriateness. ORIGINALITY/VALUE: This paper fulfils an identified need to record and evaluate the new post-acute packages introduced by the Social Services and NHS and proposes simulation as one of the most suitable methodologies for such objectives.
PURPOSE: Aims to describe a project carried out within Hampshire Social Services investigating potential care pathways for older people after discharge from hospital and to show the potential of the simulation methodology in such situations. DESIGN/METHODOLOGY/APPROACH: A discrete-event simulation was used to determine the system capacities and to estimate the likely associated reimbursement costs. FINDINGS: A prototype simulation model was developed showing the potential value of this approach. RESEARCH LIMITATIONS/IMPLICATIONS: Restrictions in data access shifted the focus from quantitative service mapping to a more descriptive approach. PRACTICAL IMPLICATIONS: Currently, many older patients experience delayed discharge from acute beds because of capacity limitations in Social Services' traditional post-acute care services. At the same time, new regulations require Local Authorities to reimburse NHS Acute Trusts if hospital discharge is delayed solely due to inadequate provision of social care assessments and services. In order to overcome the so-called "bed-blocking" problem, a new range of services termed "Intermediate Care" has been introduced to offer alternative options for older patients. These services are examined in terms of capacity and appropriateness. ORIGINALITY/VALUE: This paper fulfils an identified need to record and evaluate the new post-acute packages introduced by the Social Services and NHS and proposes simulation as one of the most suitable methodologies for such objectives.
Authors: Lauren Cadel; Sara J T Guilcher; Kristina Marie Kokorelias; Jason Sutherland; Jon Glasby; Tara Kiran; Kerry Kuluski Journal: BMJ Open Date: 2021-02-11 Impact factor: 2.692