We are keen to give people a hands-on experience of modelling and on this page can provide you with an opportunity to play.
We are developing a range of sample models that are easy to use. The first group of 4 below were developed in the context of a paper we did recently on Social Care Modelling with the SSCR (see our Publications section for the full report). .
Simply click on one of the model headings below - the model will load in 'Netsim' in a new tab in your browser; just follow the onscreen instructions from there.
When the webpage opens, you will also see a basic stock-flow diagram, one of the core elements of a System Dynamics Model, like this;
Following the 'next' button will take you to a screen where you can make your model runs. The results will be displayed on graphs - like these.
We realise that in practice no real population behaves like this - it is just a way of showing you how these models operate.
The subject of this model is any health or social care service (could be a GP clinic, a Community Psychiatric Nurse, a Hospital Outpatient department – anything similar). It models referral rates and the length of stay. Try pausing the model regularly and changing the control variables. Can you predict which lines will change and why?
This is a version of Model 2 but with a capacity constraint added, so a little bit closer to a real situation. It is an exercise in avoiding waiting lists.
In this model you need to try to ‘unblock’ the hospitals beds, possibly with the use of a ‘joint’ health and social care budget
The models we build are generally more complex (they need to reflect complex worlds after all) but they share the same principles as those behind these simple examples.
The Public Sector is no stranger to difficult decisions;
- Balancing institutional versus community-based care
- Addressing the impact of major shifts in service demand, such as long term conditions
The challenge has always been to make these huge changes, but get them right first time.
But, things can go wrong;
- The impact of change over time – we sometimes need a longer term perspective to understand, say, the impact of population change
- The impact of change across the system – sometimes success may depend on changes outside the immediate organisation
- The alternatives - sometimes these are not tested sufficiently; the usual tools (such as spreadsheets) are not capable of addressing the complexity involved
So, we offer a new approach.
Together with a team of decision makers from your organisation and your partners, we construct a model of your health and social care system and the inter-dependencies involved. This enables you to make changes within the model before delivering them on the ground. You review the results instantly, operating in a risk free environment to learn about what works. Ultimately, it means a more informed choice and one that, in the long run, is more likely to be successful.
The figure opposite represents the process we use, which we call Group Model Building. The emphasis is on the 'Group' - we work with clients, not as an external team that imposes solutions. We try firstly to understand the nature of the issue, often using Causal Maps to set out the relationships.
This forms the basis of a key element of the System Dynamics modelling process we use, called 'Stock-Flow' maps. They are a kind of care pathway but have some important distinctions:
- they are 'live' - they have data running through them
- they enable effects in one part of the system to be linked to another part of the system
- they enable us to look at changes over time
The data we use can be from a variety of sources - researched effects, local practice, 'expert' assumptions.
The results are produced in graphs that show changes in behaviour over time. This enables clients to plot impact on key output measures, looking at impact over time.
Have a look at some of our previous models.
People use 'models' all the time to help them think about the real world;
- Mental models encapsulate how we think things work. Applied, for example, to our understanding of how organistations work we might imagine them to function like computers (sequential, logical, one outcome); or, we might see them as human bodies (organic, a little unpredictable)
- Scale models are used when new buildings are being planned
- Process maps help us to picture or define a sequence of events, such as a patient's pathway through a hospital appointment
- A spreadsheet of an annual budget is, in effect, a model representing something that does not yet exist
Not all models are 'simulations' though. Simulation is worth considering where;
- A system is so complex that its likely behaviour cannot be deduced from merely looking at a diagram - so-called 'wicked' problems lend themselves especially to this approach
- We are concerned with change over time
- There are elements of risk in a planning or design process
There are numerous examples in health and social care;
- Interconnections within a hospital mean that the best improvement in elective wait times might result from the procurement of more home care
- Early intervention might cost more as the life-expectancy of people needing care increases
- Attempts to link workforce and service planning are complicated by the long lead-times before qualified staff come on-stream
- And, we can test some new thinking in service design and delivery - such as work on 'coproduced' services
In the section on 'Our Approach' we describe how we represent these relationships within our models using ‘Stock-Flow’ diagrams and ‘Connectors’. An example, simulating hospital discharge, is shown below;
Simulation models provide a risk-free environment where people involved in planning and redesigning services, or simply needing to understand how an existing service works, can work collaboratively through, and learn from, a wide range of future scenarios. The approach is especially powerful when undertaken by inter-disciplinary, multi-agency groups.
Have a look at some of our work.